Megaesophagus Microbiota - A Qualitative and Quantitative Analysis
Abstracts
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The bacterial overgrowth in the esophageal lumen in patients with megaesophagus can be responsible for recurring pulmonary infections, infectious complications caused by surgical or endoscopic procedures, and by the development of dysplasia of esophageal mucosa and cancer. In spite of this, esophageal microbiota in the megaesophagus has never been studied. The aim of this study was to analyze qualitatively and quantitatively the microbiota in Chagasic Megaesophagus in comparison to the normal esophagus. Twenty-five patients (10 men and 15 women) were prospectively studied, with ages varying from 24 to 74 years (X=49), from March to September 2000. Fifteen patient with Chagasic Megaesophagus (MG), were divided into three sub groups according to the grade of esophageal dilation: MG1 : 5 patients with Megaesophagus Grade I; MG2 : 5 patients with Megaesophagus Grade II; MG3 : 5 patients with Megaesophagus Grade III. Another group of ten patients without esophageal disease was constituted (CG). The sample collection was performed using a method especially developed to avoid contamination with microorganisms of the oral cavity and oropharynx. In MG 40% of the cultures were positive with genus predominance Streptococcus sp and concentrations that varied from 101 to 102 CFU/ml. In MG 93,3% of the cultures were positive, with great variability of bacteria and predominance of a variety of aerobic Gram-positive (Streptococcus sp was the most common) and anaerobic bacteria (Veillonella sp was most frequently), in concentrations that varied from 101 to 105 CFU /ml. The bacterial concentrations were generally more elevated in MG3 in comparison to MG1, MG2 and CG (p<0,05). It was concluded that patients with megaesophagus present a varied microbiota constituted mostly of aerobic Gram-positive and anaerobic bacteria, in concentrations that vary with the esophagus dilation degree. |
