The form for each test for dysbacteriosis contains microflora indicators, which we will decipher.
Pathogenic enterobacteria
Usually this indicator comes first on the analysis form. This group of microorganisms includes bacteria that cause acute intestinal infection(salmonella, shigella - causative agents of dysentery, pathogens typhoid fever). The detection of these microorganisms is no longer an indicator of dysbiosis, but an indicator of a serious infectious intestinal disease.
Bifidobacteria
These are the main representatives of normal intestinal microflora, the number of which in the intestine should be 95–99%. Bifidobacteria perform the important work of breaking down, digesting and absorbing various food components, such as carbohydrates; they themselves synthesize vitamins and also promote their absorption from food; with the participation of bifidobacteria, iron, calcium and other substances are absorbed in the intestine important microelements; bifidobacteria stimulate the motility of the intestinal wall and promote normal bowel movements; bifidobacteria neutralize various toxic substances that enter the intestines from the outside or formed as a result of the activity of putrefactive microorganisms. The analysis form indicates the titer of bifidobacteria, which must be at least 10 7 - 10 9. A significant decrease in the number of bifidobacteria is always a sign of severe dysbacteriosis.
Lactobacilli (lactobacillus, lactic acid microbes, lactic acid streptococci)
Second in terms of representation (5% of the total intestinal microorganisms) and most important representative normal flora. Lactobacilli, or lactic acid microbes, as their name indicates, produce lactic acid, an essential component for normal intestinal function. Lactobacilli provide antiallergic protection, promote normal bowel movements, and produce highly active lactase, an enzyme that breaks down milk sugar (lactose). In the analysis, their number should be no less than 10 6 – 10 7 . Lactobacillus deficiency can lead to the development allergic diseases, constipation, lactase deficiency.
Escherichia coli with normal enzymatic activity (Escherichia)
It should be noted that the bacteria of normal intestinal flora live by attaching to the intestinal wall and forming a film covering the intestines from the inside. All absorption in the intestine occurs through this film. Bacteria of normal intestinal microflora collectively provide 50–80% of total digestion, and also perform protective (including antiallergic) functions, neutralize the effects of foreign and putrefactive bacteria, promote bowel movements, and provide adaptation to nutrition and external influences.
Escherichia coli with reduced enzymatic activity
This is an inferior E. coli, which does not pose any harm, but does not perform its beneficial functions. The presence of this indicator in the analysis is a sign of beginning dysbiosis, as well as a decrease in the total amount of E. coli can be indirect sign the presence of worms or protozoa in the intestines.
Some analyzes describe bacteroides, the role of which is unclear, but it is known that these are not harmful bacteria; usually their quantity is of no practical importance.
All other microflora indicators are opportunistic flora. The very term “opportunistic” indicates the essence of these microbes. They become pathogenic (disrupting normal intestinal functions) under certain conditions: an increase in their absolute number or percentage of normal flora, if ineffective defense mechanisms or decreased immune system function. Opportunistic pathogenic flora are lactose-negative enterobacteria (Klebsiella, Proteus, Citrobacter, Enterobacter, Hafnia, Serration), hemolyzing Escherichia coli and various cocci (enterococci, epidermal or saprophytic staphylococci, Staphylococcus aureus). In addition, clostridia, which are not sown in all laboratories, are opportunistic pathogens. Opportunistic flora penetrates, competing with beneficial bacteria, into the microbial film of the intestines, populates the intestinal wall and causes disruption of the entire gastrointestinal tract. Intestinal dysbiosis with an increased content of opportunistic flora can be accompanied by allergic skin reactions, stool disorders (constipation, diarrhea, greens and mucus in the stool), abdominal pain, bloating, regurgitation, vomiting. In this case, the body temperature usually does not increase.
Coccal forms in the total amount of microbes
The most harmless representatives of opportunistic flora are enterococci. They are most often found in the intestines of healthy people, their amount up to 25% does not pose a threat to health. If the amount exceeds 25% (more than 10 7), this is most often associated with a decrease in normal flora. In rare cases, an increase in the number of enterococci is main reason dysfunction associated with dysbacteriosis.
Epidermal (or saprophytic) staphylococcus (S. epidermidis, S. saprophyticus)
These types of staphylococci can cause problems, but up to 25% is acceptable.
Percentage of hemolyzing cocci in relation to all coccal forms. Even among the relatively harmless cocci mentioned above, more pathogenic ones can be found, which is indicated in this position. If total cocci is, for example, 16%, and the percentage of hemolyzing cocci is 50%, this means that half of the 16% are more harmful cocci, and their percentage in relation to the normal flora is 8%.
Staphylococcus aureus (S. aureus)
One of the most unpleasant (along with hemolyzing Escherichia coli, Proteus and Klebsiella) representatives of opportunistic flora. Even small amounts of it can cause severe clinical manifestations, especially in children in the first months of life. Therefore, usually the standards given in the analysis form indicate that it should not be present (in fact, quantities not exceeding 10 3 are acceptable). Pathogenicity Staphylococcus aureus directly depends on the state of normal flora: the more bifidobacteria, lactobacilli and normal E. coli, the less harm from staphylococcus. Its presence in the intestines can lead to allergic reactions, pustular skin rashes, intestinal dysfunction. Staphylococci are common environmental microbes, in particular they live in large quantities on the skin and mucous membranes of the upper respiratory tract. The baby can get them through breast milk. Weak children (problem pregnancy, prematurity, cesarean section, artificial feeding, the use of antibiotics are risk factors for weakening the functions of the immune system). It is important to understand that staphylococci, like other opportunistic bacteria, manifest themselves under certain conditions, the main one of which is a weakened immune system, therefore, it is important to carry out immunocorrective therapy in the treatment of dysbiosis associated with staphylococcus.
Hemolyzing Escherichia coli
It is a representative of lactose-negative enterobacteria, but is distinguished separately due to its prevalence and significance. Normally it should be absent. Almost everything said about Staphylococcus aureus applies to this microbe. That is, it can cause allergic and intestinal problems, is very common in the environment (though it is almost never found in breast milk), causes problems in weakened children, and requires immunocorrection. It should be noted that the term “hemolyzing” does not mean that there is any effect on the blood. Conditionally pathogenic flora in case of dysbacteriosis should not overcome the intestinal wall and enter the blood. This is possible only with extremely pronounced forms of dysbiosis in children with severe immunodeficiencies, which, as a rule, pose a threat to life. Fortunately, such conditions are rare.
Lactose-negative enterobacteriaceae
A large group of opportunistic bacteria of greater or lesser degree of pathogenicity. Their number should not exceed 5% (or in titers: 10 3 – 10 6 – moderate increase, more than 10 6 – significant increase). The most unpleasant bacteria from this group are Proteus (most often associated with constipation) and Klebsiella (they are direct antagonists (competitors) of lactobacilli, which leads to the development of allergies and constipation, as well as manifestations of lactase deficiency). Often the analysis form indicates the total number of lactose-negative enterobacteria (the percentage is the most informative), and then there is a breakdown:
- Klebsiella;
- Proteas;
- Hafnia;
- Serrations;
- Enterobacter;
- Citrobakers.
Fungi of the genus Candida
The presence of up to 10 4 is allowed. An increase in this parameter may occur after the use of antibiotics. If the number of fungi is increased, and the amount of normal intestinal flora is sharply reduced, and candidiasis (thrush) of the visible mucous membranes (oral cavity, genitals) is noted - these are manifestations of systemic candidiasis, that is, there is an infection with intestinal fungi. If the number of fungi in the test for dysbacteriosis is increased, but there is no decrease in the normal intestinal flora, this indicates that fungi live on the skin around anus, and not in the intestines, in this case external therapy using antifungal ointments or creams is sufficient.
Clostridia
Due to technical difficulties and low practical significance, they are not determined in all laboratories. Acceptable quantity until 10 7. They usually exhibit pathogenicity in combination with other opportunistic flora, rarely causing problems in isolation (most often - loosening of stool, diarrhea). Their number depends on the function of local intestinal immunity.
Other microorganisms
This parameter describes rare species of bacteria, the most dangerous of which is Pseudomonas aerugenosa. Most often, the microorganisms described in this analysis position are of no practical importance.
The term “abs” means the absence of a given microorganism; “not detected” is also used.
Kopanev Yu.A. Sokolov A.L.
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Dysbacteriosis is a violation of not just the quantitative content of microorganisms in the intestines, but also the proportional ratio. The correct balance ensures the necessary digestion process and helps enzyme systems.
Age-related nutritional characteristics are accompanied by changes in requirements for. Therefore, what is optimal for an infant is considered a violation for an adult and vice versa.
Feces for dysbacteriosis are a complex analysis. It requires compliance:
- preliminary preparation;
- rules for collecting stool;
- isolation of each group of microorganisms;
- differentiation with pathological flora.
Some of the research requires biochemical methods; in addition, if necessary, bacteriological culture for dysbacteriosis is done on special nutrient media. Therefore, stool testing for dysbacteriosis is carried out by experienced laboratory technicians who have special training.
A little about intestinal microorganisms
More than 500 species of microorganisms live in the human intestine. Their tasks:
- help in breaking down substances ingested with food to a state that allows free passage through the wall into the bloodstream;
- remove toxins and gases that arise during the digestion process and prevent rotting;
- speed up the elimination of unnecessary harmful substances;
- produce the enzymes the body lacks for vital functions;
- synthesize essential vitamins;
- ensuring participation in the synthesis of components for immunity.
It has been proven that bifidobacteria are capable of secreting specific substances with anticancer effects.
All microorganisms are divided:
- for useful ones - they perform the above functions, maintain health (bifidobacteria - 95% of the total composition, lactobacilli up to 5%, Escherichia);
- conditionally pathogenic - become pathogenic in the presence of necessary conditions(changes in the acid-base balance of the environment, loss of immunity due to long-term or severe illness), “traitor” bacteria can become staphylococci, enterococci, clostridia, fungi of the genus Candida;
- harmful or pathogenic - when they enter the body, they cause intestinal disease (salmonella, shigella).
Helicobacter is localized in the area of the pylorus of the stomach. They are one of the important causes of gastritis, peptic ulcer and cancer. They may be isolated from the saliva and feces of an infected person. Found in 2/3 of the population.
Helicobacter is considered so far the only microorganism that survives in acidic conditions. gastric juice
Decoding the stool analysis for dysbacteriosis provides information about the quantitative and qualitative composition of the microflora, warns about dangerous deviations. According to the method of obtaining energy, microorganisms are divided:
- aerobic - viable only in the presence of oxygen (enterobacteria, lactobacilli, streptococci, staphylococci, fungi);
- anaerobic - develop without access to oxygen, are resistant (bifidobacteria, enterococci, clostridia).
Normally, the human body is protected from the spread of bacterial flora and fungi from the intestines to the stomach and other parts of the digestive tract. The obstacles are:
- hydrochloric acid of gastric juice, which destroys certain types of microorganisms;
- the presence of an ileocecal valve at the border between the ileum (the latter in small intestine) and the cecum (the initial part of the large intestine);
- a smooth muscle system that regulates peristaltic wave-like movements to push contents in one direction - from the small to the large intestine.
The ileocecal valve prevents the entry of stool with microorganisms from the bottom up
This is what happens in healthy person. Analysis of stool for dysbacteriosis may show a violation of defense mechanisms.
When is it necessary to take a stool test for dysbacteriosis?
Dysbacteriosis is not a disease, but a consequence of some disease. Usually they lead to it:
- chronic pathology of the digestive system;
- the result of inflammatory processes in the intestines with enterocolitis of various etiologies;
- use of high doses and long courses of antibiotics.
Changes in health status can be caused by a decrease in the proportion of beneficial microorganisms and an increase in the proliferation of opportunistic pathogens and pests. Specific symptoms can not be. But, given the failure in the functioning of the patient’s intestines, one should expect:
- stool disorders (alternating diarrhea and constipation);
- bloating (flatulence) due to increased fermentation processes in the intestines;
- attacks of colic;
- the appearance of undigested dietary fiber residues, mucus, blood in the feces;
- decreased appetite, insufficient weight gain in children;
- common allergic reactions;
- permanent plaque on the tongue, teeth, bad breath;
- bleeding gums;
- increased hair loss, brittle nails;
- areas of dryness and flaking on the skin;
- signs of decreased immunity, which can be judged by frequent colds, difficulties with treatment.
Patients are prescribed the necessary examination for diagnosis. To find out the role of disturbed intestinal flora, the doctor will prescribe an analysis for intestinal dysbiosis. The study is indicated for patients undergoing chemotherapy and radiation therapy to select supportive treatment.
How to get tested for intestinal dysbiosis?
To obtain reliable results, it is not enough to have qualified specialists and a well-equipped laboratory nearby. It is necessary to comply with the requirements for preparation for analysis and correctly collect feces.
The analysis for dysbacteriosis can be assessed as reliable if in the previous three days any foods that promote fermentation processes were excluded from the diet. These include:
- alcohol;
- beet;
- meat and fish dishes.
Three days before the test, stop using such medicines, How:
- antibiotics;
- laxatives of any kind (including rectal suppositories, castor and vaseline oil).
Wash the perineum and anus area well with soap before defecation. Wait for spontaneous bowel movement to collect material, do not use laxatives. This requirement is difficult for people with constant constipation. Collect stool in a sterile container, without urine. Close the sample tightly with a lid.
If you are not sure how well you can process dishes at home, it is recommended to buy a special jar at the pharmacy
In the presence of bloody discharge or mucus impurities, they must be included in the collected material. The child should be seated on a potty, previously well washed and rinsed with boiling water.
To conduct research, about 10 g of feces is enough; this is equal to a teaspoon in volume. On the lid of the vessel you should indicate the initials and surname of the patient; for a child, the date of birth, time and date when the test is taken.
The ideal way to complete the test for dysbacteriosis is to quickly deliver the container to the laboratory (no later than 40 minutes). Let's say two hours. Can be stored in the refrigerator for up to four hours, but not in the freezer. How longer delay, the more will die anaerobic microorganisms from contact with air. And this distorts the results obtained.
What methods are used to detect dysbacteriosis?
The doctor suggests passing stool first to general analysis, which is called coproscopy or scatology. It is carried out by microscopying a drop of feces diluted with distilled water.
There is no exact count of the number of bacteria. In the results, it is important for the doctor to register disturbances in the digestive process. In order to clarify the cause, biochemical or bacteriological tests are prescribed. additional research.
Biochemical method
Biochemical analysis stool test for dysbacteriosis allows you to get results in an hour. The method is based on the ability of bacteria to isolate fatty acids. By analyzing the type of acidic content, microorganisms are distinguished and localization in the intestine is determined.
The advantages of the method are:
- comparative speed;
- the possibility of extending the delivery time to the laboratory to a day;
- safety of the material when frozen in the refrigerator;
- accuracy of information.
For correct collection, in contrast to the scheme already given, it is necessary:
- provide for a period after antibiotic therapy of at least two weeks;
- women should refrain from taking the test if their periods have not completely ended;
- pick up pieces of feces from different parts.
- acetic acid 5.35–6.41;
- propylene 1.63–1.95;
- oil 1.6–1.9.
Based on the concentration of fatty acids, it can be concluded that possible composition microorganisms in the intestines.
Bacteriological culture method
Bacteriological culture stool for dysbacteriosis is a more labor-intensive research method. The analysis should be carried out as soon as possible after defecation.
Stool is inoculated onto plates containing medium containing a growth catalyst.
Bacteria multiply within 4–5 days. How much dysbacteriosis analysis is done determines the time required for the growth process. They are much larger than in biochemical research, because it is required not only to calculate a quantitative indicator, but also to identify microorganisms by their properties. Results are reported in CFU/g (colony forming units).
The normal distribution of microorganisms must correspond following diagram:
- bifidobacteria 10 8 –10 10;
- lactobacilli and Escherichia 10 6 –10 9;
- streptococci 10 5 –10 7;
- non-hemolytic staphylococci 10 4 –10 5;
- clostridia 10 3 –10 5;
- conditionally pathogenic enterobacteria 10 3 –10 4 ;
- hemolytic staphylococci less than 10 3 CFU/g.
The number of bacteria in children under one year of age breastfeeding different from adults:
- bifidobacteria make up 10 10 –10 11;
- lactobacilli 10 6 –10 7 .
Based on the disturbed ratio of microorganisms, a conclusion is drawn about intestinal dysbiosis.
The disadvantages of the method are:
- significant distortion of results depending on the delay in delivery of material;
- lack of accounting for mucosal bacteria found in the colon;
- death of anaerobic microorganisms from contact with oxygen.
The conclusion indicates the degree of dysbacteriosis
What does a stool test for dysbacteriosis show?
Based on the results of all studies, the analysis for dysbacteriosis in adults is deciphered. It takes into account the isolated microorganisms and their quantity:
The results of the analysis must be treated carefully both in terms of preventing the development of the disease in the future and when choosing the optimal treatment.
Dysbacteriosis is quite common intestinal disease both among children and adults. It is important to know not only how to properly take tests for dysbacteriosis, but also to be able to read its results.
Types of microorganisms
Lives in the human intestine great amount microorganisms actively involved in the digestion nutrients. Typically, it is prescribed to patients who have obvious signs of intestinal dysfunction, such as flatulence, diarrhea, abdominal pain, constipation, or after long-term use of antibiotics.
For staging accurate diagnosis It is necessary to take a test for dysbacteriosis. It will allow you to accurately determine the composition of the intestinal microflora.
- normal, which help intestinal function;
- opportunistic, which are normal conditions do not harm human health;
- pathogenic, which can lead to serious intestinal infections.
Bifidobacteria
Bifidobacteria make up 95% of the entire intestinal microflora and are involved in the synthesis of B vitamins and vitamin K, help in the absorption of vitamin D, inhibit the activity of pathogenic bacteria and stimulate the body's immunity.
During the first 10 days of life, the baby's intestines are colonized by different strains of bifidobacteria. Children born through caesarean section, have a low content of these microorganisms. Because of this, the risk of various infectious diseases.
The reasons for the decrease in the concentration of bifidobacteria can be stress, taking potent medicines, development of intestinal infections, sudden climate change or immune pathologies.
A decrease in the population of bifidobacteria is a clear sign of dysbiosis both in adults and children.
Lactobacilli
Lactobacilli make up 4-6% of the total species composition of intestinal microflora. They help the body maintain a constant intestinal pH, produce lactase and inhibit the development of pathogenic microflora, producing bactericidal substances for this purpose.
The child receives lactobacilli from mother's milk.
Their numbers may decline in case of intestinal infections, violation of the child’s feeding technology, severe stress or the use of potent medications.
Escherichia (E.coli)
Escherichia cohabitates with a person throughout his entire life. They take part in the synthesis of B vitamins and vitamin K, the breakdown of carbohydrates, and synthesize antibiotic-like compounds that inhibit the growth of pathogenic bacteria and stimulate the immune system.
Colonies of Escherichia may decrease due to helminthic infestations, taking bactericidal drugs, poor nutrition and intestinal infections.
In the analysis, you can also find the number of rods with reduced enzyme activity. By themselves, they do not pose any harm to the body., but increasing their populations is another diagnostic factor to determine the beginning of dysbacteriosis.
In analysis no hemolysing Escherichia coli should be detected. These bacteria produce toxic substances that have a detrimental effect on the functioning of the human nervous system and gastrointestinal tract. They can cause allergic reactions.
Bacteroides
Bacteroides are involved in the digestion of fats. Normally, they appear in the human intestines only from 8-9 months of age.
With dysbacteriosis, their colonies may increase or decrease. Population growth is associated with the presence of large amounts of fatty foods in the diet, and its decrease is associated with gastrointestinal infections or the use of bactericidal drugs.
Peptostreptococci
Normally, peptostreptococci live in the large intestine. If their colonies grow or spread to other parts, the risk of inflammation increases. These bacteria help the body digest carbohydrates and proteins in milk. Their production of hydrogen helps maintain a constant pH in the intestinal environment.
An increase in the population of peptostreptococci is provoked by a diet high in carbohydrates, intestinal infections or chronic gastrointestinal pathologies.
Enterococci
Enterococci are a component of normal intestinal microflora. They take part in the processing of carbohydrates and the synthesis of vitamins, and also provide local immune protection intestines.
Normally, the number of enterococci is equal to the number of Escherichia.
The growth of their population leads to the development of inflammation.
Provoke colony growth and decrease immune status body, helminthic infestations, food allergies, poor nutrition and a decrease in the Escherichia population.
Staphylococcus
Staphylococci are divided into pathogenic and non-pathogenic according to their properties. The first include plasmolyzing and hemolyzing. The most pathogenic is Staphylococcus aureus. Saprophytic (epidermal) staphylococcus does not cause harm to the body.
Staphylococcus aureus can enter the body of an infant or newborn through mother's milk or as intrauterine infection. Even a small concentration of it can lead to the development of symptoms of intoxication - vomiting, diarrhea, abdominal pain. The pathogenicity of staphylococcus depends on the state of the normal microflora.
If it is suppressed, the risk of developing a staphylococcal infection increases significantly.
It is important to understand not only the causes and consequences of this disease, but also to be able to correctly decipher the results of an analysis for dysbacteriosis.
Clinically, staphylococcal infection manifests itself
- fever with temperature rising to 39 degrees;
weakness; - frequent bowel movements (up to 10 times a day);
- decreased appetite;
- spasmodic pain in the abdominal area;
- bloating.
An additional blood test shows an increase in the number of leukocytes, an accelerated ESR, a decrease in concentration total protein.
Staphylococci do not belong to the normal intestinal microflora. They enter the human body through food and are transmitted through environmental objects.
Microflora | Normal in adults | Normal in children |
|
Up to 1 year | Over 1 year old |
||
Pathogenic enterobacteria | |||
Total E. coli count | 300-400 million/year | 400-1 billion/year |
|
Escherichia coli with normal enzymatic activity (Escherichia) (E. Colli) | |||
Escherichia coli with weak enzymatic properties | |||
Lactose-negative enterobacteriaceae | |||
Hemolyzing Escherichia coli | |||
Coccal forms in total amount microbes | |||
Bifidobacteria | |||
Lactobacilli | |||
Bacteroides | |||
Enterococci | |||
Eubacteria | |||
Peptostreptococci | |||
Clostridia | |||
Staphylococcus aureus (S. Aureus) | |||
Staphylococcus (saprophytic epidermal) | |||
Yeast-like fungi of the genus Candida | |||
Other opportunistic enterobacteriaceae |
|||
Klebsiella | |||
Enterobacter | |||
Serration | |||
Non-fermenting bacteria |
|||
Pseudomonas | |||
Acinetobacter | |||
Clostridia
Clostridia take part in the digestion of proteins. At the same time, they synthesize indole and skatole, which in small concentrations stimulate intestinal motility, and in large concentrations cause severe poisoning. As the concentration of clostridia increases, the amount of indole and skatole also increases, which entails the development of putrefactive dyspepsia.
The growth of clostridia colonies is influenced by the amount of protein in human food.
Candida
An increase in the number of representatives of yeast-like fungi of the genus Candida may be a consequence of taking antibiotics. When the vital activity of normal intestinal microflora is suppressed and the number of candida increases Symptoms of candidiasis appear clearly(thrush).
In children, candidiasis occurs pain syndrome in the navel area, bloating, loose stools. In some cases, the stool is foamy, mixed with mucus and blood.
Salmonella
Salmonella is a pathogenic microorganism that should not normally be present in the intestines. Its entry into the human body leads to the development infectious disease– salmonellosis.
Shigella
Shigella is a pathogenic microorganism that should not normally be present in the intestines. It causes dysentery and manifests itself as acute toxic damage to the intestines. The main routes of transmission are contaminated dairy products and water, raw fruits and vegetables, and patients with dysentery.
Composition of intestinal microflora depending on the type of child’s nutrition (fumes/g)
Microflora | Breastfeeding | Artificial feeding | Mixed feeding |
Bifidobacteria | |||
Lactobacilli | |||
Bacteroides (in children over 3 months) | |||
E. coli | |||
Lactose-lying Escherichia coli | |||
Enterococci | |||
Saprophytic staphylococci | |||
Clostridia | |||
The composition of the intestinal microflora strongly depends on the type of food the child eats. Breastfed babies are less susceptible to dysbacteriosis and intestinal infections.
Children whose diet was introduced to complementary foods in the form of nutritional mixtures have weaker microflora. Children whose feeding is entirely based on formula have the weakest microflora.
Dysbacteriosis can have serious consequences for a child's health. Therefore, it is very important to understand the reasons for its occurrence, know the basic rules of prevention and be able to correctly read the results of an analysis for dysbacteriosis.
In contact with
In a child’s body, a tendency is immediately revealed that confirms the immaturity of organs. digestive system. At the same time, this type of analysis confirms the existing imbalance in the intestinal microflora. Most often, with dysbacteriosis in infants or newborns, there is a risk of having any diseases, as a result of which a malfunction occurred in the body. In most cases, dysbiosis does not have pronounced symptoms and is usually similar to any other disease of the digestive tract. In this regard, it becomes quite difficult to determine and identify dysbiosis in the child’s body. Therefore, submitting stool for analysis is one of the reliable and accurate laboratory methods that can confirm this diagnosis.
When should you get tested for dysbacteriosis?
Sometimes the results of an analysis for the presence of dysbiosis in a child may contain a lot of unknowns. ordinary parents information. In order to shed light on the contents of such analyses, in this article we will try to study the entire range of information provided during the tests, as well as decipher its contents. Hand over this type Children need tests if the child has:
- Diseases of the digestive organs;
- Increased flatulence;
- Intolerance individual species food;
- Pain in the abdominal area;
- Antibiotic therapy.
All of the above pathologies are prerequisite taking tests for dysbacteriosis in the child’s body. In addition, this type of analysis must be done on a newborn if he is included in the category of children with the development of various intestinal pathologies. For children susceptible to various diseases, testing for dysbacteriosis is also important.
What is the purpose of testing for dysbacteriosis?
Analysis of stool for the presence of dysbiosis in the child’s body is carried out in order to refute or confirm the corresponding diagnosis. At the same time, by taking this test, you can identify the causes of discomfort in the baby’s body. Based on the data from this analysis, the attending physician makes a specific diagnosis and prescribes appropriate treatment. As a result, the baby feels much better, and the parents are happy about his recovery. By analyzing a child’s stool to confirm or refute the dysbiosis developing in the body, doctors accurately and practically without errors study the composition of its microflora and determine the concentrations of the following groups of microorganisms:
- which include microorganisms that improve the processes of digestion and absorption of nutrients for the baby;
- Opportunistic microorganisms contained in the baby’s intestines that can worsen the baby’s health. Usually this group microorganisms can be harmful to the child if the number of such bacteria exceeds the number of beneficial ones;
- Pathogenic bacteria that should not be contained in the microflora of a healthy baby at all.
Composition of a child's intestinal microflora
When examining stool for dysbacteriosis, specialists from medical institutions study in detail the composition of the resulting biomaterial. The essence of this analysis is to identify the ratio of the number of beneficial bacterial microorganisms to the number of opportunistic microorganisms, also present in the child’s body. The category of beneficial microorganisms that inhabit the child’s intestines includes: E. coli, lactobacilli, and also. All these types of microorganisms have a positive effect on health and condition child's body.
Scientists include the group of opportunistic microorganisms: fungi, clostridia, Klebsiella, and enterobacteria. Their activity can cause some discomfort to a growing child’s body and cause the child to cry. In a child’s body, each of the groups of bacterial microorganisms represented plays its role. Thus, some of the bacteria described above provide the baby with smooth digestion, while others, on the contrary, cause the development of various pathologies in the child.
The presence of pathogenic enterobacteria in a child’s stool indicates the presence of some kind of disease, since normally this category of microorganisms should not be present in the stool of healthy children. In addition, microorganisms of the genus or Shigella found in the feces of a child indicate the development in the child’s body of a rather complex intestinal disease, therefore their presence is extremely undesirable in a child’s body.
Intestinal microflora may contain microorganisms of the genus Salmonella and Shigella, as well as harmful fungal bodies belonging to the genus Candida. Fungal organisms belonging to the genus Candida can cause some discomfort to the baby. With an increased content of these fungi in the intestines, superficial damage to the skin in the anus can begin. And if these fungi actively begin to multiply and the number of beneficial microorganisms significantly decreases, the child may develop thrush or candidiasis.
Staphylococcus aureus should also not be contained in the feces of a child, especially in infancy. The presence of staphylococcus in the feces, even in small quantities, can cause various clinical manifestations in a child. These include: pustules on the skin, and intestinal disorders. Staphylococcus can easily enter a child's body through mother's milk. Children with disabilities are most susceptible to infection weak immunity. In addition to staphylococcus, hemolyzing Escherichia coli can also cause harm to a child’s body. It, like staphylococcus, is not favorable for the development beneficial microflora child's body. Pathogenic microorganisms belonging to the genus Clostridia cause diarrhea in children.
The conditionally pathogenic part of microorganisms causes discomfort to the baby only when his immune system is weakened. If this category of microorganisms actively multiplies and begins to prevail over beneficial bacteria, the baby may develop dysbiosis.
Beneficial bacteria in the baby's intestines are bifidobacteria. Thanks to their presence in the child’s body, many important processes for his body are carried out. These include:
- Stimulation of intestinal motility;
- Participation in the breakdown of food;
- Normalizes the process of bowel movement;
- Promote the absorption of vitamins;
- Provide digestion of food;
- Helps ensure the process of food absorption;
- Promote the absorption of essential microelements;
- Capable of neutralizing many toxic substances.
Is not full list the benefits and advantages of bifidobacteria, which are necessary for the growth and development of the child’s body. If there are very few bifidobacteria in the intestines, this serves as a signal for the development of dysbiosis in the child. They play a major role in the intestinal microflora. They help maintain the body's defense systems against penetration into it. various kinds allergens. Thanks to lactobacilli, the body synthesizes lactase and lactic acid, which are simply indispensable for ensuring normal intestinal function. If these lactobacilli die, the child may develop allergies, constipation and lactase deficiency. This is especially undesirable for children under the age of the first year of life.
For the microflora of a child’s body, it is important to have activities that are necessary for the healthy growth and development of the body. Thanks to microorganisms of this group, children do not have a wide distribution of pathogenic bacteria throughout the body, and oxygen, which is dangerous for the life of lactobacilli and bifidobacteria, is removed. When the amount of E. coli in the intestinal microflora decreases, helminthic infestation may occur in a child’s body.
Dysbacteriosis in a child's body is accompanied by regurgitation, diarrhea or constipation, various skin reactions, pain in the abdominal cavity, as well as stomach bloating. If your baby suffers from abdominal pain or colic, you should consult a doctor. The reason for visiting the doctor is also a disorder of the baby's stool accompanied by the baby's anxiety. The cause of all these troubles for the child’s body may be. It can only be detected by submitting the child’s stool for analysis. With the help of this analysis, the doctor will be able not only to find the cause of dysbiosis, but also to provide the baby with the necessary help.
Analysis transcript
This analysis is carried out over seven days. It is during this period of time that all data on the composition of the microflora of the baby’s feces becomes ready. After receiving the biomaterial, laboratory specialists place it in a special container with a nutrient medium, in which all microorganisms found in the feces germinate. After some time, laboratory staff count germinated bacterial spores per gram of feces and study them in detail using a microscope. Then all data on the number of germinated microorganisms is entered into a special form. The number of germinated bacteria is documented using colony-forming units, based on one gram of the biomaterial under study (COG/g).
To analyze stool, the biochemical method is used, since it is more accurate and requires much less time to complete. A gastroenterologist deciphers the results of the analysis. In his work, he is guided by the norms of age indicators for the child’s body.
Submission of biomaterial for analysis to identify the child necessary condition preventing spread throughout the child's body various pathologies. Usually, on the form with the result of the analysis of the child’s feces, there are up to eleven indicators that indicate the presence of certain microorganisms in the child’s intestinal microflora and their number. The results of the analysis contain the following indicators:
The reasons leading to a decrease in the number of E. coli are:
- Improper diet and diet, oversaturated with protein, fatty or carbohydrate foods, as well as artificial feeding;
- The development of various intestinal infections in the body.
The number of pathogenic enterobacteria that cause development in a child various diseases, should be minimal or practically absent. The presence of a large number of them in the feces of a child indicates the development of intestinal infections in his body.
Based on these indicators, you can compare the data of your analyzes and independently judge the degree of development of dysbiosis in the child’s body.
How to prepare a child for analysis?
To obtain the most accurate data on the state of the microflora of the child’s body, you should prepare a little before taking tests. A few days before the test, you should not give your child new foods that he has never eaten before. At the same time, it is worth stopping the baby from taking prescribed medications, including medications against colic in newborns. Before submitting the biomaterial for analysis, the child should not be tested and used as treatment. It should also be abandoned for a while.
Before collecting the baby's feces for analysis, it is necessary to wash it well so that the analysis does not show the presence of foreign compounds. Biomaterial should be collected after the baby has urinated, otherwise the remaining urine may get into the feces and the analysis result will be somewhat distorted.
Feces should be collected in a clean container, which should preferably be sterilized beforehand. Usually, about ten milliliters of the baby’s morning stool are taken for analysis.
After collecting the biomaterial within a period of no more than two hours, it must be delivered to the laboratory for analysis. In case of impossibility of transfer collected stool In this period of time, it can be stored in the refrigerator for up to six hours. Parents today have a huge choice of clinics and laboratories that are ready to provide services for studying the child’s biomaterial at Parents choose themselves medical institution and deliver the biomaterial there.
Intestinal dysbiosis literally means that the normal balance of beneficial bacteria in the body is disrupted. As soon as the amount of beneficial microflora decreases, pathogenic microorganisms begin to multiply in its place without delay. What exactly happens in the intestines, how can you determine intestinal dysbiosis and how to interpret the analysis for dysbiosis?
WHO LIVES IN THE INTESTINES AND WHY?
In a healthy person, the colon is inhabited by microorganisms that form the basis of the intestinal microflora; they are represented by anaerobes: lactobacilli and bifidobacteria, as well as aerobes - in other words, Escherichia coli (E. coli), which has normal enzymatic properties. Thanks to these microorganisms, the stability of the normal intestinal microflora is ensured, they prevent the colonization of foreign microorganisms in it.
It is thanks to the balance intestinal bacteria, which form the microflora, ensures normal, efficient digestion of food, and therefore the supply of necessary substances to the body, maintaining stability human body to various types of infections, that is, normal functioning of the immune system.
Opportunistic microorganisms that live in the intestines are representatives of the Enterobacteriaceae family: Enterobacter, Klebsiella, Proteus, Citrobacter, Staphylococcus, Pseudomonas aeruginosa, etc. All of them constitute a significant part of the usual normal aerobic intestinal flora (which requires an influx of oxygen for its development). As a rule, they do not cause any diseases, but, on the contrary, take part in ensuring its stable normal functioning. However, when their number begins to grow and exceed the norm, it provokes intestinal disorders, for starters.
As a result, there may appear frequent diarrhea or, on the contrary, constipation, bloating and cramping pain in the abdomen, undigested food and mucus in feces, bleeding gums, flaky skin, allergies. In addition, intestinal dysbiosis can result in brittle hair and peeling nails, decreased appetite, white coating in language and dark coating on the teeth bad smell coming from the mouth, atopic dermatitis. In general, intestinal dysbiosis provokes a decrease in the protective functions and strength of the body, and suffers the immune system person. As a consequence of this, a weakened body easily “catches” various viral and infectious diseases.
All these manifestations are especially dangerous when it comes to children, especially infants. Tests for dysbiosis in infants, and in adults too, help determine the quantity and quality of microorganisms in the intestines.
TESTS FOR DYSBACTERIOSIS IN CHILDREN
To diagnose these violations you will need microbiological analysis stool for dysbacteriosis, which makes it possible to determine the ratio of opportunistic and normal microorganisms and assess the quality of microflora in the intestines. Analysis of stool for dysbiosis, in addition, will also provide an opportunity to determine and evaluate the sensitivity of microorganisms living in the intestines to certain drugs, which will subsequently help determine the correct treatment regimen and selection of medications for this. For such an analysis, it is necessary to collect morning feces in an amount of about 5-10 grams: if the material for research is stored for a long time at room temperature, it will simply be impossible to accurately determine the microflora.
To assess intestinal functions and determine the likelihood of dysbiosis, an analysis for dysbiosis, called a coprogram, may also be useful. With its help, the ability of the intestines to digest food normally is assessed, and violations of the breakdown of food and its absorption are identified. To carry out a coprogram, you can also donate evening stool, however, in this case, feces should be stored on the bottom shelf of the refrigerator in a closed glass container.
By the way, a specialist can also assess the ability of the intestines to digest by determining the amount of carbohydrates in the stool.
The normal composition of intestinal microflora in healthy children can be found in the table below.
TABLE OF COMPOSITION OF GUT MICROFLORA IN NORMAL CHILDREN (CFU/G FECES)
ANALYSIS FOR DYSBACTERIOSIS, DECODING
What does the presence and quantity of certain microorganisms indicate when tested for intestinal dysbiosis? The breakdown of the analysis for dysbacteriosis is as follows:
PATHOGENIC ENTEROBACTERIA
It is pathogenic enterobacteria that cause a significant number of various diseases in humans. These include bacteria that cause acute intestinal infection, or AII for short. In particular, these are: salmonella, shigella - the causative agents of dysentery.
Identification of these microorganisms in stool analysis, dysbacteriosis is an indicator of a serious infectious disease developing in the intestines.
E. coli
The direct name for E. coli is Escherichia coli, or e. coli. It is a participant in the normal functioning of the intestines and is part of the microflora of the gastrointestinal tract in humans.
E. coli prevents the colonization of opportunistic microflora in the intestine, and in addition produces a number of B vitamins that are essential for the human body, and promotes the absorption of iron and calcium into the body.
In addition, it is found that E. coli has reduced enzymatic activity. This type of E. coli is defective; there is really no harm from it, but there is no benefit either. However, the presence of E. coli levels higher than normal is a sign of incipient dysbiosis. By their number, problems with microflora can be identified.
Tests for dysbacteriosis in children, in the absence of disease, that is, in the child’s normal healthy state, reveal typical E. coli in the feces in an amount of 10 7 -10 8 CFU/g - this is the norm. The number of lactose-negative E. coli present should not exceed 10 5 CFU/g, but the so-called hemolytic E. coli (or hemolyzing) should be completely absent.
Hemolytic E. coli (hemolyzing) are capable of producing toxins that affect the human nervous system and intestines. In addition, they can cause intestinal and allergic problems; normally they should not be present in the intestines and dysbiosis in stool analysis, respectively.
LACTOSE-NEGATIVE ENTEROBACTERIA
This name is given to opportunistic bacteria, a group of bacteria that interfere with normal digestion and cause dyspeptic symptoms in children, that is, heartburn, regurgitation, belching, a feeling of fullness or pressure in the abdomen.
As for the number of lactose-negative enterobacteria, it should not exceed the norm of 5%. Noting the amount in the credits, it will be: 10 4 – 10 5 - this is a moderate increase in their number.
LACTOBACTERIA
Lactobacilli are one of the most important bacteria in the lactic acid group. They break down lactose (milk sugar, as they call it) and prevent the occurrence and development of lactase deficiency. In addition, they maintain acidity in the colon at a normal level, that is, 5.5–5.6 pH. These lactic acid bacteria activate phagocytosis (the so-called process when special blood cells of the body and its tissues (phagocytes) capture and digest dead cells and pathogens of infectious diseases). Lactobacilli are very useful and are part of mother's breast milk.
BIFIDOBACTERIA
Bifidobacteria are also the most important representatives of the microflora of the human body. Tests for dysbiosis in children normally show the population of these bacteria at 95%.
The main property of bifidobacteria is inhibition of the growth of pathogenic bacteria in the intestines, inhibition of their growth and reproduction. That is why deficiency of bifidobacteria is perceived as one of the pathogenetic factors that determine long-term intestinal disorders in children.
Different strains of bifidobacteria and bacteroides appear in the baby’s gastrointestinal tract 10 days after birth. Babies born by cesarean section have significantly lower amounts of these beneficial bacteria than babies born naturally. In general, a significant decrease in bifidobacteria is a sign of severe dysbiosis in both children and adults.
ENTEROCOCCI
Enterococci are inhabitants of the normal microflora of the human gastrointestinal tract and are part of it, but they are also causative agents of pelvic organ infections and urinary tract infections.
In cases of excessive growth of enterococci, the use of bacteriophages is recommended to normalize the condition. The fact that enterococci are present in the intestines is normal, the main thing is that their number in the feces remains 10 5 - 10 8 CFU/g and normally does not exceed the total amount of E. coli in the stool dysbacteriosis analysis.
CLOSTRIDIAS
These bacteria are also part of the microflora in the normal state of the gastrointestinal tract. Normally, clostridia are contained in quantities not exceeding 10 3 – 10 5 CFU/g.
PROTEUS
Proteus is a representative of normal, stable opportunistic microflora. Proteas are recognized as sanitary indicator bacteria. That is, the number of proteas detected in the analysis for intestinal dysbiosis is considered as one of the indicators of pollution. The routes of transmission of these bacteria are nosocomial infection, or infection in cases of non-compliance with the rules of personal hygiene of a person.
KLEBSIELLA
Klebsiella is an opportunistic bacterium of the Enterobacteriaceae family, which is part of the intestinal microflora in a normal state, but at the same time it can provoke the development of a number of gastroenterological diseases in humans.
Klebsiellosis is one of the quite common nosocomial infections. In the case of large titers in the analysis for intestinal dysbiosis, treatment is carried out with bacteriophages. The norms for the presence of Klebsiella are no more than 10 4 CFU/g.
Properties of some opportunistic enterobacteria
In particular, Citrobacter, Enterobacter, Klebsiella, Proteus and other enterobacteria, with a decrease in immunity in the body, can lead to changes in intestinal function, and negative ones, the formation of various organs inflammatory processes.
BACTEROIDS
Bacteroides are opportunistic bacteria, representatives of normal human intestinal microflora. Colonization of the intestines by bacteroids occurs gradually. As a rule, they are not registered in fecal bacterial maps of children in the first six months of life. As for the content of bacteroids in children over 7 months of age and up to 1–2 years of age, it does not exceed 10 8 CFU/g.
The role of bacteroids has not yet been fully elucidated, but it has been established that they are actively involved in digestion, in the processes of lipid metabolism, and that they break down bile acids.
STAPHYLOCOCCUS
Staphylococci, if they are non-hemolytic (saprophytic, epidermal), may well be present in the body. They constitute one of the components of the group of saprophytic microflora, which enters the body from objects in our environment. As for their maximum quantity, it is strictly limited to 10 4 CFU/g of feces when tested for intestinal dysbiosis.
Staphylococcus aureus
This is a very health-threatening bacterium. Staphylococcus aureus, when analyzed for dysbiosis in infants, is especially undesirable. It can enter the body of infants through breast milk. Moreover, even very small amounts of it can cause pronounced, vivid clinical manifestations of the disease (vomiting, severe diarrhea, abdominal pain), especially in children in the first months of life, in infants. Therefore, the standards given in the test form for dysbacteriosis in infants indicate that, in principle, it should not exist.
As for the pathogenicity of Staphylococcus aureus, it is directly dependent on the state of the normal intestinal flora: the more lactobacilli, bifidobacteria, and normal E. coli there are, the less harm there is from staphylococcus.
The clinical picture of dysbacteriosis, which is caused by staphylococcus, is characterized by symptoms associated with inflammatory process in the intestines and intoxication of the body. In this case, there is an increase in temperature (up to 39 ° C), accompanied by chills and sweating, weakness, headache, sleep disturbance, poor appetite, cramping or constant pain in the abdomen, accompanied by loose, profuse stools with mucus and even blood. The frequency of stool per day when infected with staphylococcus is up to 7–10 times. Among other things, there is bloating, cramps, prolonged painful sensations along the large intestine. Blood changes are also recorded, characterized by an increase in ESR, an increase in the number of leukocytes, a shift to the left leukocyte formula, an increase in globulin and a decrease in albumin fractions; in the case of severe disease, a decrease in total protein content is observed (up to 6.1 g/l).
If the analysis for dysbacteriosis shows the presence of Staphylococcus aureus, mandatory hospitalization is required.
YEAST-LIKE FUNGI OF THE CANDIDA FAMILY
An increase in titers of yeast-like fungi of the genus Candida (Candida) may appear after the use of antibiotics and indicate dysbacteriosis. If the number of fungi of this type is increased, with a simultaneous sharp decrease in the amount of normal intestinal flora, and in addition, candidiasis is noted (thrush, in colloquial speech) visible mucous membranes ( oral cavity, genitals) - this is a manifestation of systemic chronic candidiasis, in other words, the patient’s intestines are infected with Candida fungi.
The situation when these yeast-like fungi are detected in crops up to an amount of 10 7 CFU/g of feces is assessed as direct intestinal dysbiosis. When more than a certain 10 7 CFU/g is detected in fecal cultures, the clinic indicates the generalization of the process, that is, it already indicates fungal infection of not only the mucous membranes, but also the skin and internal organs sick. If the interpretation of the analysis for dysbacteriosis gives such results, a diagnosis of candidomycosis sepsis or candidomycosis is made.
With candidomycosis in children, the pain is localized in the navel area, and there is a feeling of heaviness and bloating in the tummy. In this case, the stool is liquid or pasty with mucus, sometimes with blood or foam, with the presence of grayish-green or whitish-gray mycotic lumps or films up to 6 or more times a day.
One way or another, deciphering the analysis for dysbacteriosis according to indicators is not predetermined for children of different ages. Tests for dysbacteriosis in children may differ even normally; it even depends on the type of feeding the baby is fed. Therefore, in the end, we offer you tests for dysbiosis, interpretation depending on the type of feeding and the age of the children.
TABLE: COMPOSITION OF INTESTINAL MICROFLORA, ACCORDING TO FECAL ANALYSIS IN CHILDREN, DEPENDING ON THE TYPE OF FEEDING AND THE AGE OF THE CHILD (fumes/g)
A little more about what tests for intestinal dysbiosis say:
