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Ecological studies on intestinal microbial flora of Kenyan children with diarrhoea.

The intestinal microflora was analysed together with short-chain fatty acids (SCFA) and bile acids in faeces from nine children with acute diarrhoeal disease in Lari, Kenya. Enteric pathogens such as enteroinvasive E. coli, enteropathogenic E. coli, Yersinia enterocolitica, rotavirus, Giardia lamblia and Entamoeba histolytica were isolated either singly or in combination from diarrhoeal faecal specimens. The most striking finding in these patients was a marked reduction of anaerobes. Analysis of the SCFA revealed a significantly higher quantity of the volatile fatty acids (VFA) such as acetic, propionic, and butyric acid in recovery period faeces in comparison to diarrhoeal faeces, although no significant difference was seen in the quantity of non-volatile fatty acids. On analysing bile acids in faeces, conjugated primary bile acids were detected from all cases in diarrhoea whereas the free form of secondary bile acids was seen only in recovery. The pH of recovery faecal specimens was significantly lower than that in diarrhoeal faecal specimens. There was a parallel between the decrease in number of anaerobes and fluctuation in the amount of SCFA, showing that the drastic reduction of VFA accompanying decrease of anaerobes during the diarrhoeal state, and the rise in pH thought to arise from these facts, result in an increase of water content.