Kaneko T, Bando Y, Kurihara H, Satomi K, Nonoyama K, Matsuura N
Central Research Institute, Meiji Milk Products Co., Higashimurayama, Tokyo, Japan.
J Clin Microbiol. 1997 Dec;35(12):3181-5. doi: 10.1128/jcm.35.12.3181-3185.1997.
Fecal microflora and lactate concentrations in blood and feces obtained from a patient (a 5 year-old boy) with short-bowel syndrome (SBS) were compared during acidosis to results for the normal condition (no SBS symptoms). The taxonomical position of the lactobacilli found predominantly in the feces sample obtained 2 days before the fifth attack was also studied. The D-lactate level in serum obtained 1 day after the fourth attack was 10-fold higher than that for the normal condition, although there was not a great difference in L-lactate levels. D-Lactate (3.91 mM) and L-lactate (2.86 mM) were also detected in the feces samples collected 2 days before the fifth attack, while no lactate was detected in the feces sample for the normal condition. The counts of total fecal bacteria, especially anaerobic bacteria such as members of the family Bacteroidaceae, were found to be low. The counts of lactobacilli and the total population of lactobacilli relative to total fecal bacteria in the feces 2 days before the fifth attack (40.4%) were extremely high. In this case, a majority of the lactobacilli were D-lactate producers as determined by homolactic fermentation. These lactobacilli were identified as Lactobacillus delbrueckii subsp. lactis. The percentages of bifidobacteria relative to total fecal bacteria in feces samples obtained both 2 days before the fifth attack (50.9%) and for normal condition (61.9%) were also high, although these bacteria were L-lactate producers. In the feces samples for the normal condition, the D-lactate producers decreased to less than 10(9) per g, while the counts of L- or DL-lactate producers were 100-fold higher than the numbers in feces samples obtained 2 days before the fifth attack. These results suggested that an increase in the level of D-lactate producers, such as L. delbrueckii subsp. lactis, in the colon may be associated with the clinical expression of metabolic acidosis.
对一名患有短肠综合征（SBS）的患者（一名5岁男孩）在酸中毒期间与正常状态（无SBS症状）下血液和粪便中的粪便微生物群以及乳酸浓度进行了比较。还研究了在第五次发作前两天获得的粪便样本中主要发现的乳酸杆菌的分类地位。第四次发作后1天获得的血清中D-乳酸水平比正常状态高10倍，尽管L-乳酸水平没有很大差异。在第五次发作前两天采集的粪便样本中也检测到了D-乳酸（3.91 mM）和L-乳酸（2.86 mM），而正常状态的粪便样本中未检测到乳酸。发现粪便总细菌数量，尤其是厌氧细菌，如拟杆菌科成员的数量较低。第五次发作前两天粪便中乳酸杆菌的数量及其相对于粪便总细菌的总数（40.4%）极高。在这种情况下，通过同型乳酸发酵确定，大多数乳酸杆菌是D-乳酸生产者。这些乳酸杆菌被鉴定为德氏乳杆菌乳酸亚种。在第五次发作前两天获得的粪便样本（50.9%）和正常状态（61.9%）中，双歧杆菌相对于粪便总细菌的百分比也很高，尽管这些细菌是L-乳酸生产者。在正常状态的粪便样本中，D-乳酸生产者减少到每克少于10^9，而L-或DL-乳酸生产者的数量比第五次发作前两天获得的粪便样本中的数量高100倍。这些结果表明，结肠中D-乳酸生产者（如德氏乳杆菌乳酸亚种）水平的增加可能与代谢性酸中毒的临床表现有关。
