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Impact of the Ileal Microbiota on Surgical Site Infections in Crohn's Disease: A Nationwide Prospective Cohort.
Julien, Clément; Anakok, Emré; Treton, Xavier; Nachury, Maria; Nancey, Stéphane; Buisson, Anthony; Fumery, Mathurin; Filippi, Jérôme; Maggiori, Léon; Panis, Yves; Zerbib, Philippe; François, Yves; Dubois, Anne; Sabbagh, Charles; Rahili, Amine; Seksik, Philippe; Allez, Matthieu; Lefevre, Jérémie H; Le Corff, Sylvain; Bonnet, Anna; Beyer-Berjot, Laura; Sokol, Harry.
Afiliación
  • Julien C; Department of Gastrointestinal Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille Univ., Chemin des Bourrely, 13015 Marseille, France.
  • Anakok E; Sorbonne Université, UMR CNRS 8001, LPSM, 75005 Paris, France.
  • Treton X; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Saint Antoine Hospital, Gastroenterology Department, F-75012 Paris, France.
  • Nachury M; Gastroenterology Department Hôpital Beaujon, MICI et Assistance Nutritive, Clichy, France.
  • Nancey S; Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.
  • Buisson A; Gastroenterology Department, Lyon Sud Hospital, Hospices Civils de Lyon, and INSERM U1111, CIRI, Lyon, France.
  • Fumery M; Gastroenterology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
  • Filippi J; Hepatogastroenterology Department, Amiens University Hospital, Amiens, France.
  • Maggiori L; Gastroenterology Department, Hopital Archet 2, Nice, France.
  • Panis Y; Digestive, Oncologic, and Endocrine Surgery Department, Hôpital Saint-Louis, AP-HP, Université de Paris, Paris, France.
  • Zerbib P; Department of Colorectal Surgery, Beaujon Hospital and University of Paris, France.
  • François Y; Digestive Surgery and Transplantation, Claude Huriez Hospital, CHRU de Lille, Lille Université Nord de France, Lille, France.
  • Dubois A; Surgery Department, Lyon Sud Hospital, Hospices Civils de Lyon , Lyon, France.
  • Sabbagh C; Surgery Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
  • Rahili A; Surgery Department, Amiens University Hospital, Amiens, France.
  • Seksik P; Surgery Department, Hopital Archet 2, Nice, France.
  • Allez M; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Saint Antoine Hospital, Gastroenterology Department, F-75012 Paris, France.
  • Lefevre JH; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France.
  • Le Corff S; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France.
  • Bonnet A; Sorbonne Université, Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012, Paris, France.
  • Sokol H; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France.
J Crohns Colitis ; 16(8): 1211-1221, 2022 Aug 30.
Article en En | MEDLINE | ID: mdl-35218661
BACKGROUND AND AIMS: Surgery is performed in 50-70% of Crohn's disease [CD] patients, and its main risk is surgical site infection [SSI]. The microbiota has been extensively assessed in CD but not as a potential risk factor for septic morbidity. The objective of this study was to assess the impact of the gut microbiota on SSI in CD. METHODS: We used the multicentric REMIND prospective cohort to identify all patients who experienced SSI after ileocolonic resection for CD, defined as any postoperative local septic complication within 90 days after surgery: wound abscess, intra-abdominal collection, anastomotic leakage or enterocutaneous fistula. The mucosa-associated microbiota of the ileal resection specimen was analysed by 16S gene sequencing in 149 patients. The variable selection and prediction were performed with random forests [R package VSURF] on clinical and microbiotal data. The criterion of performance that we considered was the area under the Receiver Operating Characteristic [ROC] curve [AUC]. RESULTS: SSI occurred in 24 patients [16.1%], including 15 patients [10.1%] with major morbidity. There were no significant differences between patients with or without SSI regarding alpha and beta diversity. The top selected variables for the prediction of SSI were all microbiota-related. The maximum AUC [0.796] was obtained with a model including 14 genera, but an AUC of 0.78 had already been obtained with a model including only six genera [Hungatella, Epulopiscium, Fusobacterium, Ruminococcaceae_ucg_009, Actinomyces and Ralstonia]. CONCLUSION: The gut microbiota has the potential to predict SSI after ileocolonic resection for CD. It might play a role in this frequent postoperative complication.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn / Microbioma Gastrointestinal Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn / Microbioma Gastrointestinal Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido