Metagenomic analysis of appendectomy samples

Acute appendicitis is one of the most common general surgical emergencies worldwide, with an estimated lifetime risk reported to be 7 to 8%. Accordingly, appendectomy is one of the most frequently performed surgical procedures worldwide and represents an important burden on modern health systems. Despite being so common, a poor understanding of the causes of appendicitis and an absence of reliable discriminators for disease severity still persist. An insufficient amount of clinical research has led to uncertainty about best practice, with subsequent international variation in delivery and, as a possible consequence, variation in outcome. The aim of this review is to provide a state-of-the-art update about the existing controversies in pathogenesis, diagnosis, and clinical management of acute appendicitis. Culture-independent techniques, which can identify bacteria on the basis of the nucleic acid sequence of 16S ribosomal RNA (rRNA) molecules, have recently revolutionized the understanding of the complex intestinal bacterial ecology associated with various diseases. Therefore, using these specimens, we analyzed the microbial community structure by 16S rRNA gene sequencing with next-generation sequencer.