Clinical ResearchMucosal flora in inflammatory bowel disease*
Section snippets
Patients
The study was approved by the institutional review board, and the patients gave informed consent. Twenty-eight patients with self-limiting colitis, 104 patients with indeterminate colitis, 119 patients with ulcerative colitis (UC), 54 patients with Crohn's disease (CD), and 40 asymptomatic controls with normal colonoscopic findings were studied at the Charité, the University Hospital of the Humboldt University in Berlin. These patients were referred for evaluation and therapy by family
Bacterial concentration
The concentrations of mucosal bacteria were low in asymptomatic controls and high in patients with bowel inflammation, especially in patients with CD (Table 3).The bacterial concentrations in self-limiting and indeterminate colitis were intermediate. The percent of patients with >10,000 cfu/μL was significantly higher in IBD (P < 0.001) than in the other groups. Figure 1 shows the percent of patients with concentrations of mucosal bacteria of <1000, <10,000, <50,000, and >50,000 cfu/μL.
Discussion
Using a simple and reliable protocol of biopsy wash followed by hypotonic lysis, we showed that the mucosal surface in healthy controls is basically sterile and that the concentrations of mucosal bacteria increased progressively from self-limiting colitis to indeterminate colitis to IBD, being highest in CD patients.
Similar to previous studies, we found no principal difference in the composition of the mucosal flora in IBD patients and controls.4, 15, 16, 17 Species isolated from the washed
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Address requests for reprints to: Alexander Swidsinski, M.D., Innere Klinik, Gastroenterologie, Charité, 10098 Berlin, Germany. e-mail: [email protected]; fax: (011) 49 30 450 514 923.