Changes in the gut microbiome in colon cancer surgery patients: a pilot observational study. Colon cancer microbiota

Between March and September, 2019 we included 27 adult patients who were scheduled to undergo elective colorectal cancer surgery. We performed a prospective descriptive observational study whose primary aim was to evaluate changes in the gut microbiome before and after surgery, and to evaluate the effect of different prophylaxis regimens (standard prophylaxis with cefuroxime and metronidazole versus carbapenems for ESBL-E carriers). We obtained rectal sample before and 3 days after surgery, and an intraoperative intraluminal stool sample. We performed metataxonomics analysis based on sequencing of the bacterial 16S rRNA gene marker.We observed large and significant increases in the genus Enterococcus between both the preoperative and intraoperative samples and the post-operative sample, mainly driven by Enterococcus faecalis. There were significant differences in the postoperative microbiome between patients who received standard prophylaxis and carbapenems, specifically in the family Erysipelotrichaceae. Preoperative haemoglobin and prealbumin levels were associated to post-operative differences in gut microbiome.

2019年3月至9月，我们纳入27名拟行结直肠癌择期手术的成年患者。本研究为前瞻性描述性观察研究，首要目标为评估手术前后肠道微生物组的变化，并探究不同预防方案的效果：针对产超广谱β-内酰胺酶肠杆菌（ESBL-E）携带者，对比头孢呋辛联合甲硝唑的标准预防方案与碳青霉烯类药物预防方案的差异。我们分别于术前、术后3天采集直肠样本，并采集术中肠腔内粪便样本，并基于细菌16S rRNA基因标记物测序开展宏分类组学（metataxonomics）分析。研究观察到，肠球菌属（Enterococcus）在术前、术中样本与术后样本中均出现显著且大幅的丰度提升，该变化主要由粪肠球菌（Enterococcus faecalis）介导。接受标准预防方案与碳青霉烯类药物预防的患者，其术后肠道微生物组存在显著差异，该差异具体聚焦于红蝽菌科（Erysipelotrichaceae）。术前血红蛋白与前白蛋白水平与术后肠道微生物组的差异存在显著相关性。