Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P < 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.

Important differences were observed between the gut microbiota of children living under distinct socioeconomic and environmental conditions within the same city. Our findings suggest that children of high socioeconomic status have less favorable gut microbiota than do children who live in poverty.

OBJETIVO: Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores socioeconômicos e ambientais, peso, estatura e hemoglobina, em crianças de dois estratos socioeconômicos, no município de Osasco (SP). MÉTODOS: Estudo transversal, comparando 84 crianças de seis a dez anos, residentes em área sem saneamento básico e moradia precária, com 35 crianças de escola particular no mesmo município, que possuíam boas condições socioeconômicas e de moradia. Excluíram-se aquelas com diarreia há menos de 30 dias ou doença grave. Utilizou-se questionário padronizado para avaliar as condições socioambientais. A avaliação nutricional foi realizada mediante escores Z de peso para idade, estatura para idade e índice de massa corpórea. A determinação da hemoglobina em amostra de sangue capilar foi realizada pelo método Hemocue® e a pesquisa de parasitas intestinais, pelos métodos de Hoffman, Ritchie, Kinyoun e swab anal. RESULTADOS: Parasitose intestinal ocorreu em 60,7% das crianças da favela e em 5,9% das crianças da escola particular (p<0,001; OR 24,7). A média dos escores Z de peso para idade, estatura para idade e índice de massa corpórea foi menor nas crianças parasitadas (-0,78±0,84; +0,50±0,90; -0,76±0,96) em relação àquelas não parasitadas (-0,18±1,18; +0,03±1,10; -0,28±1,16), sendo as diferenças estatisticamente significantes (p<0,05). Não houve diferença nos valores médios de hemoglobina entre as crianças parasitadas e não parasitadas do grupo da favela (12,6±1,1g/dL e 12,8±1,2g/dL); p=0,58. CONCLUSÕES: A parasitose intestinal foi mais prevalente em crianças da favela e se associou a menores índices de peso e de estatura.

Apropos: ''Gut Microbiota Differences in Children From Distinct Socioeconomic Levels Living in the Same Urban Area in Brazil''T o the Editor: The study authored by Mello et al (1) introduces a novel insight by comparing the human gut microbial composition in children living in the same geographic area, stratified by socioeconomic status. The authors, however, make conclusions that are not supported by the author's study results or methods. The authors failed to properly explain how the community leaders and researchers defined the classification requirements for a ''slum'' within the study area. Mello et al discussed the location of the perceived ''slum'' and presented example pictures of the area; however, detailed criteria to what constituted as a ''slum'' are missing and lead readers to believe slums were identified subjectively. A subjective approach to identifying ''slums'' will lead to selection bias drastically skewing the study results.In addition, the authors do not discuss the study's significant limitations, including the lack of a food diary collection, a crucial measure for establishing a baseline dietary picture for each study participant. Even though the authors discussed the differential dietary categories among the groups, it is curious that the authors decided not to do any kind of dietary data collection/analysis for this study group.Finally, it is crucial, even in studies not evaluating microbiota composition dynamics over time, to collect multiple samples to effectively judge the accuracy and consistency of the sample collection process. These practices will reduce error and increase confidence in eventual study conclusions.Future human gut microbiota-related studies must take greater care and deference in sound study design to avoid these problems in the future.