Microbiome Dysbiosis With Enterococcus Presence in the Upper Gastrointestinal Tract Is a Risk Factor for Mortality in Patients Undergoing Surgery for Pancreatic Cancer

作者：Christoph K. Stein‐Thoeringer, Bernhard W. Renz, Juliana de Castilhos, Viktor von Ehrlich-Treuenstätt, Ulrich Wirth, Tengis Tschaidse, Felix O. Hofmann, Dominik Koch, Iris Beirith, Steffen Ormanns, Markus Guba, Martin K. Angele, Joachim Andrassy, Hanno Nieß, Jan D’Haese, Jens Werner, Matthias Ilmer · 发表于：Annals of Surgery · 年份：2024 · DOI：10.1097/sla.0000000000006210 · 被引用次数：23 · 研究领域：Gut microbiota and health、Pancreatic and Hepatic Oncology Research、Surgical site infection prevention

BACKGROUND: Recent retrospective studies suggest a role for distinct microbiota in the perioperative morbidity and mortality of pancreatic head resections. OBJECTIVE: We aimed to prospectively investigate the microbial colonization of critical operative sites of pancreatic head resections to identify microbial stratification factors for surgical and long-term oncologic outcomes. METHODS: Prospective biomarker study applying 16S rRNA sequencing and microbial culturing to samples collected from various sites of the gastrointestinal tract and surgical sites of patients during pancreatic head resections at a German single high-volume pancreatic center. RESULTS: A total of 101 patients were included {38 noncancer, 63 cancer patients [50 pancreatic ductal adenocarcinoma (PDAC) patients]} in the study. In a first data analysis series, 16S rRNA sequencing data were utilized from 96 patients to assess associations of microbiome profiles with clinical parameters and outcomes. In general, microbiome composition varied according to sampling site, cancer, age or preoperative endoscopic retrograde cholangiopancreatography (ERCP) intervention, notably for the bile microbiome. In the PDAC subcohort, the compositional variance of the bile or periampullary microbiome was significantly associated with postoperative complications such as intensive care unit admission; on a taxonomic level we observed Enterococcus spp. to be significantly more abundant in patients developing deep or organ-space s...