Gut microbiome patterns correlate with higher postoperative complication rates after pancreatic surgery

• Published in: BMC microbiology 2019-02, Vol.19 (1), p.42-42, Article 42
• Main Authors: Schmitt, Felix C F, Brenner, Thorsten, Uhle, Florian, Loesch, Svenja, Hackert, Thilo, Ulrich, Alexis, Hofer, Stefan, Dalpke, Alexander H, Weigand, Markus A, Boutin, Sébastien
• Format: Article
• Language: English
• Subjects: 16S RNA gene sequencing; Aged; Algorithms; Antibiotics; Bacteria - classification; Bacteria - isolation & purification; Clinical medicine; Communities; Complications and side effects; Digestive system; DNA sequencing; Feces - microbiology; Gastrointestinal Microbiome; Gastrointestinal tract; Gene sequencing; Genes; Genomes; Gut microbiome; High-Throughput Nucleotide Sequencing; Humans; Inflammation; Intensive care; Intestinal microflora; Intestine; Microbial activity; Microbiomes; Microbiota; Microbiota (Symbiotic organisms); Microorganisms; Middle Aged; Next-generation sequencing; Nosocomial infections; Odds Ratio; Pancreas; Pancreatectomy; Pancreatic Diseases - surgery; Pathogenic microorganisms; Pathogens; Patients; Phylogeny; Pilot Projects; Postoperative complications; Postoperative Complications - microbiology; Prospective Studies; Risk Factors; RNA; RNA, Ribosomal, 16S - genetics; rRNA 16S; Sepsis; Surgery; Surgical outcomes
• ISSN: 1471-2180; 1471-2180
• DOI: 10.1186/s12866-019-1399-5

Postoperative complications are of great relevance in daily clinical practice, and the gut microbiome might play an important role by preventing pathogens from crossing the intestinal barrier. The two aims of this prospective clinical pilot study were: (1) to examine changes in the gut microbiome following pancreatic surgery, and (2) to correlate these changes with the postoperative course of the patient. In total, 116 stool samples of 32 patients undergoing pancreatic surgery were analysed by 16S-rRNA gene next-generation sequencing. One sample per patient was collected preoperatively in order to determine the baseline gut microbiome without exposure to surgical stress and/or antibiotic use. At least two further samples were obtained within the first 10 days following the surgical procedure to observe longitudinal changes in the gut microbiome. Whenever complications occurred, further samples were examined. Based on the structure of the gut microbiome, the samples could be allocated into three different microbial communities (A, B and C). Community B showed an increase in Akkermansia, Enterobacteriaceae and Bacteroidales as well as a decrease in Lachnospiraceae, Prevotella and Bacteroides. Patients showing a microbial composition resembling community B at least once during the observation period were found to have a significantly higher risk for developing postoperative complications (B vs. A, odds ratio = 4.96, p