Gut Microbiota Features in Young Children with Acute Pyelonephritis Depending on The Type of Feeding

Abstract

Background. The gut is a major reservoir of uropathogens, and its microbiota during the first years of life is substantially influenced by feeding type. This relationship has been insufficiently studied in young children with acute pyelonephritis.

Objective. To compare gut microbiota parameters in children aged 0–36 months with acute pyelonephritis who received breastfeeding or formula feeding.

Materials and methods. The study included 147 children: 57 breastfed patients with acute pyelonephritis (group I), 55 patients formula-fed from birth (group II), and 35 healthy breastfed children (group III). Fecal samples were examined before antibacterial therapy by real-time polymerase chain reaction using the Enteroflor Deti reagent kit.

Results. Group II had the lowest total bacterial mass (8.46±0.13 lg GE/g), proportion of normal microbiota (85.80±1.33%), taxonomic diversity, and levels of Bifidobacterium spp., Lactobacillaceae, the Clostridium leptum group, and Akkermansia muciniphila (p≤0.05 compared with group I). The proportion of opportunistic microbiota was 10.66±2.01%, versus 5.98±1.00% in group I and 3.61±0.19% in healthy children. Enterobacterales and Escherichia coli levels were higher in both patient groups than in controls.

Conclusion. In young children with acute pyelonephritis, formula feeding was associated with more pronounced dysbiotic shifts, whereas the microbiota composition of breastfed patients was closer to that of healthy children. The cross-sectional design does not allow causal inference.

Keywords:

Acute pyelonephritis, young children, breastfeeding, formula feeding

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