Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN, USA.
Sci Rep. 2022 Jun 22;12(1):10559. doi: 10.1038/s41598-022-14819-1.
The intestinal microbiota has been implicated in the pathogenesis of complications following colorectal surgery, yet perioperative changes in gut microbiome composition are poorly understood. The objective of this study was to characterize the perioperative gut microbiome in patients undergoing colonoscopy and colorectal surgery and determine factors influencing its composition. Using Illumina amplicon sequencing coupled with targeted metabolomics, we characterized the fecal microbiota in: (A) patients (n = 15) undergoing colonoscopy who received mechanical bowel preparation, and (B) patients (n = 15) undergoing colorectal surgery who received surgical bowel preparation, composed of mechanical bowel preparation with oral antibiotics, and perioperative intravenous antibiotics. Microbiome composition was characterized before and up to six months following each intervention. Colonoscopy patients had minor shifts in bacterial community composition that recovered to baseline at a mean of 3 (1-13) days. Surgery patients demonstrated substantial shifts in bacterial composition with greater abundances of Enterococcus, Lactobacillus, and Streptococcus. Compositional changes persisted in the early postoperative period with recovery to baseline beginning at a mean of 31 (16-43) days. Our results support surgical bowel preparation as a factor significantly influencing gut microbial composition following colorectal surgery, while mechanical bowel preparation has little impact.
肠道微生物群与结直肠手术后并发症的发病机制有关，但围手术期肠道微生物组组成的变化尚不清楚。本研究的目的是描述接受结肠镜检查和结直肠手术患者的围手术期肠道微生物组，并确定影响其组成的因素。我们使用 Illumina 扩增子测序结合靶向代谢组学，对以下患者的粪便微生物群进行了特征描述：（A）接受机械肠道准备的结肠镜检查患者（n=15），以及（B）接受机械肠道准备联合口服抗生素和围手术期静脉内抗生素的结直肠手术患者（n=15）。在每次干预前后都对微生物组组成进行了特征描述。结肠镜检查患者的细菌群落组成有轻微变化，平均在 3（1-13）天内恢复到基线。手术患者的细菌组成发生了显著变化，肠球菌、乳杆菌和链球菌的丰度增加。在术后早期，组成变化持续存在，平均在 31（16-43）天开始恢复到基线。我们的研究结果支持手术肠道准备是结直肠手术后肠道微生物组成发生显著变化的一个重要因素，而机械肠道准备的影响较小。
