Zhong Diana, Brower-Sinning Rachel, Firek Brian, Morowitz Michael J
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA; Division of Pediatric Surgery, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.
J Pediatr Surg. 2014 Mar;49(3):441-6. doi: 10.1016/j.jpedsurg.2013.06.026.
Although luminal obstruction has traditionally been viewed as the underlying cause of appendicitis, recent evidence has suggested that the disease may result directly from invasion by specific pathogens, e.g. Fusobacterium nucleatum. The purpose of this study was to survey microbial communities within pediatric appendectomy specimens using a culture-independent approach.
We performed 16S ribosomal gene sequence analysis to profile the microbiota present within luminal fluid obtained from 22 pediatric appendectomy specimens. These included 10 simple appendicitis cases, 5 perforated appendicitis cases, 2 interval appendectomies, and 5 incidental appendectomies.
Samples could be divided into 2 distinct clusters based upon the composition of the appendiceal bacterial communities. Appendicitis samples contained an increased abundance of Fusobacterium spp. and a reduced abundance of Bacteroides spp. relative to non-appendicitis cases. Appendicitis samples also contained variable amounts of other oral taxa such as Porphyromonas, Parvimonas, and Gemella, whereas these taxa were generally absent from non-appendicitis samples.
Acute appendicitis is associated with an abundance of Fusobacterium spp. and other pathogens commonly found in the oral cavity. Further research is needed to determine whether these organisms directly cause appendicitis or rather proliferate in the appendix as a secondary consequence of inflammation.
尽管传统上认为管腔阻塞是阑尾炎的根本原因，但最近的证据表明，该病可能直接由特定病原体（如具核梭杆菌）入侵引起。本研究的目的是使用一种不依赖培养的方法来调查小儿阑尾切除标本中的微生物群落。
我们进行了16S核糖体基因序列分析，以描绘从22例小儿阑尾切除标本中获得的管腔内液体中存在的微生物群。这些标本包括10例单纯性阑尾炎病例、5例穿孔性阑尾炎病例、2例间隔期阑尾切除术和5例意外阑尾切除术。
根据阑尾细菌群落的组成，样本可分为2个不同的簇。与非阑尾炎病例相比，阑尾炎样本中具核梭杆菌属的丰度增加，拟杆菌属的丰度降低。阑尾炎样本中还含有不同数量的其他口腔类群，如卟啉单胞菌、微小单胞菌和孪生球菌，而非阑尾炎样本中通常没有这些类群。
急性阑尾炎与大量存在于口腔中的具核梭杆菌属和其他病原体有关。需要进一步研究以确定这些微生物是直接导致阑尾炎，还是作为炎症的继发后果在阑尾中增殖。
