The microbiome of the appendix differs in patients with and without appendicitis: A prospective cohort study.


Journal

Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347

Informations de publication

Date de publication:
01 Apr 2024
Historique:
received: 24 11 2023
revised: 16 02 2024
accepted: 19 02 2024
medline: 3 4 2024
pubmed: 3 4 2024
entrez: 2 4 2024
Statut: aheadofprint

Résumé

Appendicitis seems to be a disease of infectious origin, but the detailed pathogenesis is unknown. We aimed to investigate the microbiome of the appendix lumen in patients with and without appendicitis, including a comparison of the subgroups of complicated versus uncomplicated appendicitis. This prospective observational cohort study included adult patients undergoing laparoscopic appendectomy for suspected appendicitis. According to histopathologic findings, the investigated groups consisted of patients with and without appendicitis, including subgroups of complicated versus uncomplicated appendicitis based on the surgical report. A swab of the appendix lumen was analyzed for genetic material from bacteria with shotgun metagenomics, and outcomes included analyses of microbiome diversity and differential abundance of bacteria. A total of 53 swabs from patients with suspected appendicitis were analyzed: 42 with appendicitis (16 complicated) and 11 without appendicitis. When comparing patients with and without appendicitis, they were equally rich in bacteria (alpha diversity), but the microbiome composition was dissimilar between these groups (beta diversity) (P < .01). No consistent bacterial species were detected in all patients with appendicitis, but a least 3 genera (Blautia, Faecalibacterium, and Fusicatenibacter) and 2 species, Blautia faecis and Blautia wexlerae, were more abundant in patients without appendicitis. For the subgroups complicated versus uncomplicated appendicitis, both measures for microbiome diversity were similar. The appendix microbiome composition of genetic material from bacteria in adult patients with and without appendicitis differed, but the microbiome was similar for patients with complicated versus uncomplicated appendicitis. Trial registration NCT03349814.

Sections du résumé

BACKGROUND BACKGROUND
Appendicitis seems to be a disease of infectious origin, but the detailed pathogenesis is unknown. We aimed to investigate the microbiome of the appendix lumen in patients with and without appendicitis, including a comparison of the subgroups of complicated versus uncomplicated appendicitis.
METHODS METHODS
This prospective observational cohort study included adult patients undergoing laparoscopic appendectomy for suspected appendicitis. According to histopathologic findings, the investigated groups consisted of patients with and without appendicitis, including subgroups of complicated versus uncomplicated appendicitis based on the surgical report. A swab of the appendix lumen was analyzed for genetic material from bacteria with shotgun metagenomics, and outcomes included analyses of microbiome diversity and differential abundance of bacteria.
RESULTS RESULTS
A total of 53 swabs from patients with suspected appendicitis were analyzed: 42 with appendicitis (16 complicated) and 11 without appendicitis. When comparing patients with and without appendicitis, they were equally rich in bacteria (alpha diversity), but the microbiome composition was dissimilar between these groups (beta diversity) (P < .01). No consistent bacterial species were detected in all patients with appendicitis, but a least 3 genera (Blautia, Faecalibacterium, and Fusicatenibacter) and 2 species, Blautia faecis and Blautia wexlerae, were more abundant in patients without appendicitis. For the subgroups complicated versus uncomplicated appendicitis, both measures for microbiome diversity were similar.
CONCLUSION CONCLUSIONS
The appendix microbiome composition of genetic material from bacteria in adult patients with and without appendicitis differed, but the microbiome was similar for patients with complicated versus uncomplicated appendicitis. Trial registration NCT03349814.

Identifiants

pubmed: 38565493
pii: S0039-6060(24)00117-X
doi: 10.1016/j.surg.2024.02.020
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03349814']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Auteurs

Siv Fonnes (S)

Centre for Perioperative Optimisation, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Denmark. Electronic address: siv.fonnes@gmail.com.

Sarah Mollerup (S)

Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Denmark.

Sarah Juel Paulsen (SJ)

Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Denmark.

Barbara Juliane Holzknecht (BJ)

Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Henrik Westh (H)

Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Jacob Rosenberg (J)

Centre for Perioperative Optimisation, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.

Classifications MeSH