P1968 - Small Bowel Bacterial Overgrowth in Patients of Chronic Diarrhea in South India

Madhura Prasad, MD, Mohan Prasad VG, DM, MIthra Prasad, DM, Vamsi Murthy, DM
VGM Hospital, Coimbatore, Tamil Nadu, India

Introduction: Patients with chronic Small Intestinal Bacterial Overgrowth (SIBO ) may suffer from weight loss , steatorrhea, vitamin deficiency of fat-soluble vitamins (A, D, E, K) and Vitamin B12, apart from mineral deficiencies like Iron. In addition they develop hypoproteinemia/ hypoalbuminemia. A prospective ,open label trial was done in a tertiary care teaching hospital in South India to study the prevalence of bacterial population that infect these individuals.

Methods: 154 consecutive patients presenting with chronic diarrhea with or without malabsorption were enrolled. Patients who were exposed to PPIs or antibiotics in the previous 2 weeks were excluded. All patients were subjected to endoscopicbiopsies and aspiration of jejunal fluid which was plated within 10 minutes of collection. Microbial culture was done using BD Phoenix^™ automated identification and susceptibility testing system.

Results: More than 10⁵ organisms were seen in 11.68% ( 18 pts: 8 Diabetic 10 non-diabetic ) (E Coli, Streptococcus, Citrobacter, Klebsiella, Psedomons in the order of prevalence).10⁴ to 10⁵ organisms were seen in 43.50% (49 pts : 5 Diabetic 44 non-diabetic) and 10³ TO 10⁴ organisms were seen in 31.81% (E Coli, Klebsiella,Burkholderiasepacia, Psedomonas, streptococcus, Staphylococcus aureus, acinetobacterbaumannii, Enterobacter, Enterococcus in the orderof prevalence).

86.99% of these patients had significant growth of organisms. Using the same culture system, anaerobic culture was done in 50 patients which did not pick up any organisms.In 90% of these patients, the chronic diarrhea resolved with appropriate antibiotics.

Discussion: Endoscopic aspirate of jejunal fluid culture , often times missed is an important diagnostic armamentarium in successful therapy of patient with chronic diarrhea .


Disclosures:


Madhura Prasad, MD, Mohan Prasad VG, DM, MIthra Prasad, DM, Vamsi Murthy, DM. P1968 - Small Bowel Bacterial Overgrowth in Patients of Chronic Diarrhea in South India, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.