The gut microbiota in adults with chronic intestinal failure

Objective: Fecal microbiota was investigated in adult patients with chronic intestinal failure (CIF) due to short bowel syndrome (SBS) with jejunocolonic anastomosis (SBS -2). Few or no data are available on SBS with jejunostomy (SBS -1) and CIF due to intestinal dysmotility (DYS) or mucosal disease (MD). We pro filed the fecal microbiota of various pathophysiological mechanisms of CIF. Methods: Cross-sectional study on 61 adults with CIF (SBS -1 30, SBS -2 17, DYS 8, MD 6). Fecal samples were collected and pro filed by 16S rRNA amplicon sequencing. Healthy controls (HC) were selected from pre-existing cohorts, matched with patients by sex and age. Results: Compared to HC, SBS -1, SBS -2 and MD patients showed lower alpha diversity; no difference was found for DYS. In beta diversity analysis, SBS -1, SBS -2 and DYS groups segregated from HC and from each other. Taxonomically, the CIF groups differed from HC even at the phylum level. In particular, CIF patients' microbiota was dominated by Lactobacillaceae and Enterobacteriaceae , while depleted in typical healthassociated taxa belonging to Lachnospiraceae and Ruminococcaceae . Notably, compositional peculiarities of the CIF groups emerged. Furthermore, in the SBS groups, the microbiota pro file differed according to the amount of parenteral nutrition required and the duration of CIF. Conclusions: CIF patients showed marked intestinal dysbiosis with microbial signatures speci fic to the pathophysiological mechanism of CIF as well as to the severity and duration of SBS. (c) 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.