|Publication Type||Journal Article|
|Year of Publication||2015|
|Authors||Rosen, R, Hu, L, Amirault, J, Khatwa, U, Ward, DV, Onderdonk, A|
|Date Published||2015 Apr|
|Keywords||Adolescent, Bacteria, Bronchoalveolar Lavage Fluid, Bronchoscopy, Child, Child, Preschool, Cross-Sectional Studies, DNA, Bacterial, Electric Impedance, Endoscopy, Gastrointestinal, Esophageal pH Monitoring, Female, Follow-Up Studies, Gastroesophageal Reflux, Humans, Infant, Laryngoscopy, Lung, Male, Oropharynx, Prospective Studies, Proton Pump Inhibitors, Stomach|
OBJECTIVES: To test the hypothesis that proton pump inhibitor (PPI) use results in changes in gastric microflora which, through full column reflux, results in lung and oropharyngeal microflora changes.
STUDY DESIGN: We performed a prospective, cross-sectional cohort study of 116 children (57 off and 59 on PPIs) undergoing simultaneous bronchoscopy and upper endoscopy for the evaluation of chronic cough. We performed 16S sequencing on gastric, bronchoalveolar lavage, and oropharyngeal fluid. Fifty patients also underwent multichannel intraluminal impedance testing.
RESULTS: Streptococcus was more abundant in the gastric fluid of patients taking PPIs, and there was a significant correlation with PPI dose (mg/kg/d) and abundance of gastric Streptococcus (P = .01). There was also a significant difference in the abundance of oropharyngeal Streptococcus in patients treated with PPI. Eight unique bacterial genera were found in the gastric and lung fluid but not in the oropharyngeal suggesting exchange between the 2 sites and 2 of the 8 (Lactococcus, Acinetobacter) were more abundant in patients with more full column reflux, suggesting direct aspiration. Principal component analysis revealed greater overlap between gastric and lung than oropharyngeal microflora.
CONCLUSIONS: PPI use was associated with differences in gastric, lung, and oropharyngeal microflora. Although microflora exchange can occur between all 3 sites, gastric and lung microflora are more closely related, and the mechanism of exchange between sites may be aspiration of full column reflux.
|Alternate Journal||J. Pediatr.|
|PubMed Central ID||PMC4380592|
|Grant List||K23 DK073713 / DK / NIDDK NIH HHS / United States |
R03 DK089146 / DK / NIDDK NIH HHS / United States
R03DK089146 / DK / NIDDK NIH HHS / United States