Real-Time PCR Analysis of the Intestinal Microbiotas in Peritoneal Dialysis Patients

Abstract

Bifidobacterium and Lactobacillus can beneficially affect the host by producing acetic acid and lactic acid, which lower pH and thereby inhibit the growth of pathogens or allow the probiotic bacteria to compete with pathogens for epithelial adhesion sites and nutrients. The transmural migration of enteric organisms into the peritoneal cavity can cause peritonitis in peritoneal dialysis (PD) patients. We hypothesized that the composition of the intestinal microbiota with regard to Lactobacillus species and Bifidobacterium species differed between PD patients and healthy controls. The aim of the study was to investigate these differences by real-time PCR analysis of fecal samples. There is a large, complex, and diverse microbial community in the human intestine. The intestinal microbiota plays an important role in digesting food, metabolizing endogenous and exogenous compounds, and producing essential vitamins. It also stimulates the immune system and prevents the colonization of the gastrointestinal tract by pathogens, and hence it influences human health (7, 9). The gastrointestinal microbiota of an adult human consists of more than 500 species, with 10 11 to 10 12 CFU per gram of stool (12,25). The predominant microorganisms are non-spore-forming, obligate anaerobes, such as Bacteroides, Fusobacterium, Eubacterium, and Bifidobacterium species. Other anaerobic bacteria found in large numbers include Lactobacillus species, various anaerobic Gram-positive cocci, and Clostridium species (4). Hida et al. studied the fecal flora of hemodialysis (HD) patients and healthy controls using traditional plating methods and found quantitative and qualitative differences between the two groups (13). It is plausible to suggest that the chronic inflammatory state in dialysis patients is in part due to a microbial imbalance in the gut, resulting in alteration of proinflammatory cytokines and production of uremic toxins from proteins fermented in the large intestine (16). Moreover, impaired intestinal barrier function in peritoneal dialysis (PD) patients allows enteric organisms to enter the peritoneal cavity by transmural migration and to cause peritonitis (8,27). Peritonitis occasionally causes death and results in significant morbidity, including catheter loss, transfer to hemodialysis, transient loss of ultrafiltration, and possible permanent membrane damage (22). Bifidobacterium and Lactobacillus can beneficially affect the host by inhibiting the growth of pathogens through production of acetic acid and lactic acid, which lower pH, or by competing with pathogens for epithelial adhesion sites and nutrients (10).To the best of our knowledge, no study has investigated the intestinal microbiota in PD patients before. The aim of this study, therefore, was to evaluate the differences in the intestinal microbiota between PD patients and healthy controls by examining fecal samples. We focused on Bifidobacterium species, Lactobacillus species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species....

Comamonas testosteroni-associated peritonitis in a pediatric peritoneal dialysis patient

“…In fact, in PD patients, bacterial peritonitis induces a subsequent breakdown of intestinal barrier function and a transient impairment of host mucosal immune defense [16] . This may have allowed further enteric lowvirulence organisms to enter the peritoneal cavity by transmural migration and to cause peritonitis [17] . C. testosteroni should be kept in mind as a rare cause of bacterial peritonitis in children receiving chronic PD.…”

Kronik Böbrek Hastalığında Bağırsak Mikrobiyotası ve Diyet Posasının Rolü

“…KBH'da bağırsak mikrobiyotasının değiştiği ve intestinal geçirgenliğin arttığı hem insan hem hayvan modellerinde yapılan çalışmalarda gösterilmiştir (46,(53)(54)(55)(56). KBH'da disbiyotik bakterilerin çoğalması sonucu konakla mikrobiyom arasındaki simbiyotik ilişki bozulmaktadır.…”

The cross-talk between the kidney and the gut: implications for chronic kidney disease

“…Studies have shown that CKD has been associated with altered colonic microbiota composition [5,10,74,75]. Significant differences in the abundance of numerous microbial operational taxonomic units (OTUs) were observed when feces of CKD patients were compared with that of normal renal functional subjects.…”