Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
Front Cell Infect Microbiol. 2021 Apr 29;11:625589. doi: 10.3389/fcimb.2021.625589. eCollection 2021.
The pathogenesis of choledocholithiasis is closely related to the role of bacteria. However, little is known about the predictive role of bile bacteria in clinical conditions of patients and the compositional and functional characteristics of biliary microbiota in choledocholithiasis.
To investigate the predictive value of biliary bacteria, clinical data of 488 patients with choledocholithiasis were collected. The predictive value of common bile bacteria to patients' clinical conditions was analyzed by logistic regression. Samples of bile and corresponding duodenal juice from 10 selected patients with choledocholithiasis were obtained, and the composition and function of microbial communities were analyzed based on rRNA sequencing and Tax4Fun.
The clinical conditions of patients with choledocholithiasis, such as recurrence, the severity of acute cholangitis, and duration of hospital stay were closely related to different species of bile bacteria as well as antimicrobial-resistant bacteria. Employing rRNA sequencing, the dominant phyla of biliary and duodenal microbiota were and . The top three core microbiota at the genus level were , and . accounted for the most abundant annotated species in both. Differences in composition between biliary and duodenal microbiota were not significant according to the alpha and beta diversities. Differential abundant features were not found in biliary microbiota indicated by A linear discriminant analysis effective size algorithm. The major pathways identified in biliary and duodenal microbiota were related to membrane transport, translation, replication and repair, carbohydrate and amino acid metabolism. However, no significant difference in those major pathways, as well as antimicrobial-resistance patterns, was observed between biliary and duodenal microbiota.
Our study first demonstrates the predictive contribution of biliary bacteria to the clinical conditions of patients with choledocholithiasis, and then it offers new insights into the compositional and functional features of biliary and duodenal microbiota. Similarities between biliary and duodenal microbiota support the theory of bacterial duodenal-biliary reflux in patients with choledocholithiasis. Meanwhile, when it is impracticable to obtain a bile sample, duodenal juice may be used as an alternative for bacterial culture and susceptibility tests.
胆石病的发病机制与细菌的作用密切相关。然而，对于胆汁细菌在患者临床状况中的预测作用以及胆石病患者胆汁微生物群落的组成和功能特征知之甚少。
为了研究胆汁细菌的预测价值，收集了 488 例胆石症患者的临床资料。通过逻辑回归分析，分析了常见胆汁细菌对患者临床状况的预测价值。从 10 例胆石症患者中抽取胆汁和相应的十二指肠液样本，基于 rRNA 测序和 Tax4Fun 分析微生物群落的组成和功能。
胆石症患者的临床情况，如复发、急性胆管炎的严重程度和住院时间，与胆汁细菌以及抗菌药物耐药菌的不同种属密切相关。通过 rRNA 测序，胆汁和十二指肠微生物群的优势门分别为 和 。属水平的前三个核心微生物群分别为 、 和 。这两个部位的微生物群落组成在α和β多样性方面没有显著差异。胆汁微生物群落中没有发现差异丰富特征，这表明通过 A 线性判别分析有效大小算法指示。胆汁和十二指肠微生物群落中鉴定的主要途径与膜转运、翻译、复制和修复、碳水化合物和氨基酸代谢有关。然而，在胆汁和十二指肠微生物群落中，没有观察到这些主要途径以及抗菌药物耐药模式存在显著差异。
本研究首次证明了胆汁细菌对胆石症患者临床状况的预测贡献，然后为胆汁和十二指肠微生物群落的组成和功能特征提供了新的见解。胆汁和十二指肠微生物群落之间的相似性支持了胆石症患者细菌十二指肠-胆汁反流的理论。同时，当无法获得胆汁样本时，十二指肠液可作为细菌培养和药敏试验的替代物。
