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BMC Microbiol. 2019 Feb 18;19(1):42. doi: 10.1186/s12866-019-1399-5.

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

Author information

1
Department of Anesthesiology, Heidelberg University Hospital, 110, Im Neuenheimer Feld, D-69120, Heidelberg, Germany. Felix.Schmitt@med.uni-heidelberg.de.
2
Department of Anesthesiology, Heidelberg University Hospital, 110, Im Neuenheimer Feld, D-69120, Heidelberg, Germany.
3
Department of General, Visceral and Transplant Surgery, Heidelberg University Hospital, Heidelberg, Germany.
4
Department of Anesthesiology, Kaiserslautern Westpfalz Hospital, Kaiserslautern, Germany.
5
Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany.
6
Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.
7
Institute of Medical Microbiology and Hygiene, Technical University Dresden, Dresden, Germany.

Abstract

BACKGROUND:

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.

RESULTS:

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 < 0.01**; B vs. C, odds ratio = 2.89, p = 0.019*).

CONCLUSIONS:

The structure of the gut microbiome is associated with the development of postoperative complications.

KEYWORDS:

16S RNA gene sequencing; Gut microbiome; Inflammation; Pancreas; Postoperative complications; Sepsis

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