2025 Henri Boulard Award Winner F. Chirdo

3 Questions to Fernando Chirdo

What is the relationship between your project and Microbiota?

The gut microbiome is only beginning to be understood. Most studies have primarily focused on bacterial composition, largely due to the widespread use of 16S rRNA–based methodologies. However, our knowledge of other components of the microbiome, such as fungi and viruses, remains very limited. The microbiome and its metabolites play a crucial role in shaping a healthy gut environment through multiple mechanisms, including anti-inflammatory effects, maintenance of epithelial barrier integrity, promotion of tissue repair, and defense against pathogens. In this context, when the microbiome is altered, these protective functions can be lost, leading to gut damage. Enteric infections, antibiotic use, and certain medications can induce dysbiosis, that may have serious effects on gut health.

How your project can help in the management of chronic diarrhea in pediatric patients in Argentina?

Diarrhea is a major global health problem, especially for children under five years old in low- and middle-income countries. Most cases are caused by short-term infections, but some children develop chronic diarrhea, which lasts longer than four weeks. Chronic diarrhea can lead to serious problems such as poor nutrition, delayed growth, and a lower quality of life. Treatment approaches differ widely. In many cases, the antibiotic metronidazole is often used without clear evidence of infection, raising concerns about side effects and antibiotic resistance. Probiotics may help by shortening the duration of diarrhea, preventing repeated episodes, and reducing diarrhea caused by antibiotics. However, consensus guidelines emphasize that probiotic use should be based on high-quality clinical trials due to heterogeneity in strains, doses, and protocols. Pediatric chronic diarrhea in children is a complex condition that requires better diagnostic tools, coordinated treatment strategies, and evidence-based protocols.

How the Henri Boulard Award will help your team to perform your project?

The Henri Boulard Award would provide essential support and structure to carry out this pilot study. The Children’s Hospital in La Plata is a major referral center for Buenos Aires Province, the most populated region in Argentina. In our gastroenterology unit, we see about 100 children each year with chronic diarrhea of unknown cause. With this study, we expect to see faster recovery and weight gain in patients, fewer daily bowel movements, a reduction in total stool volume, improved stool consistency, and positive changes in gut microbiota. The results of this pilot study will also help plan a larger clinical study and contribute to the development of a standardized treatment protocol for children with chronic diarrhea.