Romano-Bertrand Sara, Frapier Jean-Marc, Calvet Brigitte, Colson Pascal, Albat Bernard, Parer Sylvie, Jumas-Bilak Estelle
Equipe Pathogènes et Environnements, UMR 5119 ECOSYM, Université Montpellier 1 Montpellier, France ; Département d'Hygiène Hospitalière, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
Front Microbiol. 2015 Jan 13;5:787. doi: 10.3389/fmicb.2014.00787. eCollection 2014.
Human skin associated microbiota are increasingly described by culture-independent methods that showed an unexpected diversity with variation correlated with several pathologies. A role of microbiota disequilibrium in infection occurrence is hypothesized, particularly in surgical site infections. We study the diversities of operative site microbiota and its dynamics during surgical pathway of patients undergoing coronary-artery by-pass graft (CABG). Pre-, per-, and post-operative samples were collected from 25 patients: skin before the surgery, superficially and deeply during the intervention, and healing tissues. Bacterial diversity was assessed by DNA fingerprint using 16S rRNA gene PCR and Temporal Temperature Gel Electrophoresis (TTGE). The diversity of Operational Taxonomic Units (OTUs) at the surgical site was analyzed according to the stage of surgery. From all patients and samples, we identified 147 different OTUs belonging to the 6 phyla Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes, Cyanobacteria, and Fusobacteria. High variations were observed among patients but common themes can be observed. The Firmicutes dominated quantitatively but were largely encompassed by the Proteobacteria regarding the OTUs diversity. The genera Propionibacterium and Staphylococcus predominated on the preoperative skin, whereas very diverse Proteobacteria appeared selected in peri-operative samples. The resilience in scar skin was partial with depletion in Actinobacteria and Firmicutes and increase of Gram-negative bacteria. Finally, the thoracic operative site presents an unexpected bacterial diversity, which is partially common to skin microbiota but presents particular dynamics. We described a complex bacterial community that gathers pathobionts and bacteria deemed to be environmental, opportunistic pathogens and non-pathogenic bacteria. These data stress to consider surgical microbiota as a "pathobiome" rather than a reservoir of individual potential pathogens.
通过非培养方法对人体皮肤相关微生物群的描述越来越多，这些方法显示出意想不到的多样性，其变化与多种病理状况相关。据推测，微生物群失衡在感染发生中起作用，尤其是在手术部位感染中。我们研究了冠状动脉搭桥术（CABG）患者手术过程中手术部位微生物群的多样性及其动态变化。从25名患者身上采集了术前、术中及术后样本：手术前的皮肤、手术过程中的浅表层和深层组织以及愈合组织。使用16S rRNA基因PCR和时间温度凝胶电泳（TTGE）通过DNA指纹图谱评估细菌多样性。根据手术阶段分析手术部位操作分类单元（OTU）的多样性。从所有患者和样本中，我们鉴定出147个不同的OTU，它们属于厚壁菌门、放线菌门、变形菌门、拟杆菌门、蓝细菌门和梭杆菌门这6个门。患者之间观察到高度差异，但也能观察到一些共同特征。在数量上厚壁菌门占主导，但就OTU多样性而言，变形菌门在很大程度上涵盖了厚壁菌门。丙酸杆菌属和葡萄球菌属在术前皮肤上占主导，而在围手术期样本中出现了非常多样的变形菌门。瘢痕皮肤的恢复能力部分存在，放线菌门和厚壁菌门减少，革兰氏阴性菌增加。最后，胸部手术部位呈现出意想不到的细菌多样性，部分与皮肤微生物群相同，但具有独特的动态变化。我们描述了一个复杂的细菌群落，其中聚集了致病共生菌以及被认为是环境菌、机会致病菌和非致病菌的细菌。这些数据强调应将手术微生物群视为“病理生物群落”，而不是单个潜在病原体的储存库。
