Fecal Microbial Profiling of Young Hirschsprung Disease Children After Pull-Through Operation

Introduction: This study aimed to characterize and compare the fecal microbial profiles between post pull-through Hirschsprung disease patients and healthy children aged younger than five years. Method: Fresh fecal samples were collected from 10 post pull-through Hirschsprung disease patients and age range-matched 10 healthy children. Bacterial DNA obtained from fecal samples were analyzed using 16S rRNA Illumina MiSeq platform. Results: Our findings demonstrated the significantly increased Firmicutes in Hirschsprung disease group compared to the healthy group (corrected p-value=0.007) at the phylum level. In addition, the Firmicutes/ Bacteroidetes ratio in Hirschsprung disease group was 4.8 times higher than that of its control counterpart. Bacilli were also significantly increased (corrected p-value=0.004), while Erysipelotrichi and Actinobacteria were significantly decreased in Hirschsprung disease patients (corrected p-value=0.04 and 0.03, respectively) at the class level. Moreover, functional analysis demonstrated that 20 enzymes and 18 Kyoto Encyclopedia of Genes and Genomes pathways were significantly different between groups (corrected p-value<0.01). Conclusion: A distinct dysbiosis even when the aganglionic segment had already been removed was remarkably evident in young children with Hirschsprung disease, with a significant increase in Firmicutes and a nearly five-fold increase in proportion of Firmicutes/Bacteroidetes which may potentially be employed as the dysbiosis-related biological indicator.