Effect of specialized enteral nutrition formula enriched with probiotics on nutritional status and gut microbiota in children with cystic fibrosis

Cystic fibrosis (CF) is characterized by chronic intestinal inflammation and bacterial overgrowth syndrome. Small bowel obstruction due to viscosity of all digestive secretions and repeated courses of antibiotic therapy may cause the overgrowth of opportunistic pathogens and other intestinal microecological disorders in CF. The large intestinal microbiota in children with CF has not been sufficiently studied, and the possibilities for its correction using specialized products for enteral nutrition have not been investigated. Objective. To evaluate the clinical effect and tolerability of the specialized enteral nutrition formula Resource® Optimum in children with CF aged 7 to 18 years. Patients and methods. This prospective comparative study included 13 children with CF, mean age: 9.2 (± 4.0) years. Clinical and anamnestic characteristics, nutritional status, microbiological diagnosis, PCR analysis of the large intestinal microbiota, fecal calprotectin concentrations, and serum albumin levels were analyzed. A specialized therapeutic formula for enteral nutrition containing Lactobacillus paracasei strain (probiotics) and dietary fiber (prebiotics) was used to correct nutritional status. Results. After 1 month of Resource® Optimum intake, children’s weight increased on average by 1.5 kg (p = 0.00), height by 1.1 cm (p = 0.04), and BMI by 0.5 kg/m2 (p = 0.00). Fecal calprotectin levels before and after correction corresponded to moderately elevated values with a downward trend. Lactobacillus spp. strains were slightly reduced: 6.2 copies/mL and 5.2 copies/mL at visits 1 and 2, respectively (reference range: 7–8 copies/mL), Bifidobacterium spp. strains were within the reference range. The amount of Clostridium perfringens and Fusobacterium nucleatum decreased statistically significantly with Resource® Optimum intake. Conclusion. The experience of using a specialized therapeutic formula for enteral nutrition containing probiotics and prebiotics to treat nutrient deficiency in children with CF aged 7–18 years indicates its clinical efficacy in correcting both protein-energy undernutrition and gut microbiota.