SPECTRUM OF ENTEROPATHOGENS IN CHILDREN WITH INFLAMMATORY BOWEL DISEASES
Abstract
Background. Alterations in intestinal microbiota composition are considered one of the key triggers of inflammatory bowel disease (IBD). Studying the spectrum of enteropathogens in children with IBD helps clarify the role of an infectious factor in the disease manifestation and progression. Objective. To characterize the spectrum of enteropathogens and their associations with clinical forms of IBD in children using molecular genetic methods. Material and Methods. A total of 118 pediatric patients with IBD were examined: 36 with Crohn’s disease (CD), 54 with ulcerative colitis (UC), and 28 with indeterminate colitis (IC). Enteropathogens were identified using the TaqMan Array Card platform (Applied Biosystems, USA) covering 34 pathogens. Statistical analysis included the χ² test, Fisher’s exact test, and 95% confidence intervals. Results. Enteropathogens were detected in 56.8% (67/118) of patients with IBD. Bacteria were identified significantly more often (61.2%) than viruses and protozoa (6% each). The predominant bacterial agent was Clostridioides difficile (74.6%), found both as a single infection and within mixed infections (p<0.001). Mixed bacterial infections accounted for 24%, mainly in UC patients (p=0.01). Among viruses, rotavirus was the most frequent, while Blastocystis predominated among protozoa. Enteropathogens were significantly less common in IC patients (p<0.001).
Conclusion. More than half of children with IBD harbored concomitant enteropathogens, confirming the significance of an infectious factor in disease modulation. The predominance of C. difficile and the high rate of mixed infections in
ulcerative colitis emphasize the role of microbiota imbalance and support the necessity of routine molecular screening in the diagnostic algorithm for pediatric IBD. The findings highlight the need for further investigation of infectioninflammation interactions to improve prevention and therapeutic strategies.
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