T. Kaneko et al., FECAL MICROFLORA IN A PATIENT WITH SHORT-BOWEL SYNDROME AND IDENTIFICATION OF DOMINANT LACTOBACILLI, Journal of clinical microbiology, 35(12), 1997, pp. 3181-3185
Fecal microflora and lactate concentrations in blood and feces obtaine
d from a patient (a 5 year-old boy) with short-bowel syndrome (SBS) we
re compared during acidosis to results for the normal condition (no SB
S symptoms), The taxonomical position of the lactobacilli found predom
inantly in the feces sample obtained 2 days before the fifth attack wa
s also studied, The D-lactate level in serum obtained 1 day after the
fourth attack was 10-fold higher than that for the normal condition, a
lthough there was not a great difference in L-lactate levels, D-Lactat
e (3.91 mM) and L-lactate (2.86 mM) were also detected in the feces sa
mples collected 2 days before the fifth attack, while no lactate was d
etected in the feces sample for the normal condition, The counts of to
tal fecal bacteria, especially anaerobic bacteria such as members of t
he family Bacteroidaceae, were found to be low, The counts of lactobac
illi and the total population of lactobacilli relative to total fecal
bacteria in the feces 2 days before the fifth attack (40.4%) were extr
emely high, In this case, a majority of the lactobacilli were D-lactat
e producers as determined by homolactic fermentation, These lactobacil
li were identified as Lactobacillus delbrueckii subsp, lactis, The per
centages of bifidobacteria relative to total fecal bacteria in feces s
amples obtained both 2 days before the fifth attack (50.9%) and for no
rmal condition (61.9%) were also high, although these bacteria were L-
lactate producers, In the feces samples for the normal condition, the
D-lactate producers decreased to less than 10(9) per g, while the coun
ts of L- or DL-lactate producers were 100-fold higher than the numbers
in feces samples obtained 2 days before the fifth attack, These resul
ts suggested that an increase in the level of D-lactate producers, suc
h as L. delbnteckii subsp, lactis, in the colon may be associated with
the clinical expression of metabolic acidosis.