Bacterial colonization of the upper intestine in mild tropical malabsorption

The bacterial flora of the upper intestine has been examined in symptomatic expatriate adults with mild tropical malabsorption, without steatorrhoea, persisting for many months after return to a western environment. Seven of the 11 patients had enterobacteria in luminal fluid or mucosal samples in numbers ranging from 10 3 to 10 8 per ml or per g. The most common isolate was Klebsiella pneumoniae (in four cases); Citrobacter freundii, Serratia marcescens and Pseudomonas spp . were also detected. The significance of bacterial colonization in the pathogenesis of mild tropical malabsorption is discussed.