Duodenal microflora: a prospective study in pediatric gastrointestinal disorders.

Culture of the duodenal microflora was performed on 96 infants and children with a variety of gastrointestinal disorders. The resident microflora consists predominantly of oral-type microorganisms such as alpha-Streptococci and Neisseria. A fecal-type microflora was found in all 6 infants with post-surgical diarrhea and temporary monosachcaride intolerance; 4 of 22 patients with protracted diarrhea of infancy, 3 of 22 patients with celiac disease, and none of 32 patients with nonspecific diarrhea or 14 others with miscellaneous disorders. Anaerobic microorganisms were seldom isolated. Only 9% of the duodenal cultures were completely sterile, although a further 17 had a quantitative culture less than 5 times 10(4) microorganisms/ml. Small-bowel contamination with fecal-type microorganisms is associated with stasis and disturbance of the normal peristaltic-clearing mechanism. Duodenal culture is essential in any infant with temporary monosaccharide intolerance. It is occasionally useful in other situations where motility may be disturbed.