{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:27:02Z","timestamp":1791404822750,"version":"4.3.3"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small intestinal bacterial overgrowth (SIBO) is a clinical and diagnostic challenge in pediatric intestinal failure. This study aimed to assess SIBO and dysbiosis in children with intestinal failure and to analyze clinical characteristics as well as cultural and metagenomic sequencing results from different sampling methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Descriptive, single\u2010center cohort study in intestinal failure patients with prospective collection of intraluminal aspirate, epithelial brush swab, mucosal biopsy, and small bowel stoma stool for SIBO diagnosis, defined as \u226510\n                      <jats:sup>3<\/jats:sup>\n                      \u2009CFU\/ml of enteric, colonic\u2010type bacteria, and microbiome analysis via whole\u2010genome sequencing. Statistical testing included receiver operating characteristic analysis, chi\u2010square test, and independent samples\n                      <jats:italic>t<\/jats:italic>\n                      test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010four children with intestinal failure were analyzed (median age 58 months; female 48%; short bowel syndrome 70%). Sixty\u2010six percent of samples were positive for SIBO. In 93%, all three endoscopic sampling methods showed congruent results. SIBO\u2010positive cases were associated (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) with small bowel dilatation, proton pump inhibitor use, intestinal inflammation, elevated direct bilirubin and hepatocellular enzyme levels, and a history of liver fibrosis and central venous catheter infections. Metagenomic sequencing revealed microbial dysbiosis in intestinal failure patients, with SIBO\u2010positive cases showing higher microbial reads, lower alpha diversity, and increased abundance of Enterobacteriaceae and enteric anaerobes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SIBO and dysbiosis are common in children with intestinal failure and associated with liver injury, central line\u2013associated bloodstream infections, and intestinal inflammation. Cultural diagnosis of SIBO using mucosal biopsies or brush swabs are alternatives to small bowel aspirates. Metagenomic sequencing is feasible, and high microbial read numbers are indicative of SIBO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpen.2808","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T04:45:13Z","timestamp":1753764313000},"page":"964-974","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Small intestinal bacterial overgrowth and dysbiosis in children with intestinal failure: A descriptive cohort study"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0055-7452","authenticated-orcid":false,"given":"Johannes","family":"Hilberath","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology University Children's Hospital T\u00fcbingen T\u00fcbingen 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