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Impact of the Ileal Microbiota on Surgical Site Infections in Crohn’s Disease: A Nationwide Prospective Cohort

2022; Oxford University Press; Volume: 16; Issue: 8 Linguagem: Inglês

10.1093/ecco-jcc/jjac026

1876-4479

C Julien, Emré Anakok, Xavier Tréton, Maria Nachury, Stéphane Nancey, Anthony Buisson, Mathurin Fuméry, Jérôme Filippi, Léon Maggiori, Yves Panís, Philippe Zerbib, Yves François, Anne Dubois, Charles Sabbagh, Amine Rahili, Philippe Seksik, Matthieu Allez, Jéremie H. Lefèvre, Pierre Cattan, Mircéa Chirica, Nicolas Munoz‐Bongrand, Hélène Corte, Nathan Beaupel, J. Catry, Jean‐Marc Gornet, Clotilde Baudry, Nelson Lourenço, Mariane Maillet, My‐Linh Tran‐Minh, Victor Chardiny, Joëlle Bonnet, Leïla Chedouba, A Nisard, Laurent Beaugerie, Anne Bourrier, Isabelle Nion–Larmurier, Julien Kirchgesner, Cécilia Landman, Elodie Quévrain, Loïc Brot, Najim Chafaı̈, Yann Parc, Clothilde Debove, Magali Svreck, Camille Vincent, Nathalie Guedj, Marianne Ferron, Yoram Bouhnik, Olivier Corcos, Carmen Stéfanescu, Sarah Khabil, Philippe Marteau, Xavier Dray, Ulrika Chaput, Gilles Bommelaer, Marion Goutte, Jérémie Denizot, Nicolas Barnich, Dilek Çoban, Pierre Desreumaux, Benjamin Pariente, Coralie Sommeville, Jean‐Louis Dupas, Julien Loreau, Franck Brazier, Denis Chatelain, Christophe Attencourt, Martine Leconte, Gilles Boschetti, Bernard Flourié, Eddy Cotte, Anne-Laure Charlois, Peggy Falgon, Helena Hadjisavvas, Driffa Moussata, Marion Chauvenet, Sarah Boyer, Xavier Hébuterne, Nadia Arab, R. Barhoumi, Paul Hofmann, Sylvain Le Corff, Anna Bonnet, Laura Beyer‐Berjot, Harry Sokol,

Microscopic Colitis

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.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].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].The gut microbiota has the potential to predict SSI after ileocolonic resection for CD. It might play a role in this frequent postoperative complication.