Divergent Resilience of Bacterial and Fungal Gut Microbiota after Colorectal Surgery: Insights from a prospective longitudinal cohort study

The gut microbiota evolves throughout life and is shaped by various external influences, with major physical stressors such as surgery exerting significant effects. However, the extent and clinical relevance of these changes remain insufficiently understood. This prospective cohort study at the University Medical Centre Freiburg investigated perioperative shifts in the gut bacterial and fungal communities in patients undergoing colorectal surgery, and identified factors influencing these alterations. Paired pre- and postoperative fecal samples from 59 patients were analyzed using 16S rRNA and ITS2 gene sequencing. Microbial diversity was assessed via alpha and beta diversity metrics, and further analyzed through LEfSe differential feature analysis and correlation with clinical variables. The identified responses of bacterial and fungal communities underscore the importance of examining the full microbiome in perioperative care. The identified microbial interkingdom interactions suggest a potential role for fungi in maintaining gut homeostasis and microbial stability during surgical recovery.