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Article dans une revue

Impact of the Ileal Microbiota on Surgical Site Infections in Crohn’s Disease: A Nationwide Prospective Cohort

Clément Julien 1 Emré Anakok Xavier Treton 2 Maria Nachury 3 Stéphane Nancey 4 Anthony Buisson 5 Mathurin Fumery 6, 7 Jérôme Filippi 8 Léon Maggiori 9 Yves Panis 10 Philippe Zerbib 11 Yves François Anne Dubois 12 Charles Sabbagh 13, 14 Amine Rahili 8 Philippe Seksik 15 Matthieu Allez 9 Jérémie Lefevre 16 Pierre Cattan 9 Mircea Chirica 17 Nicolas Munoz-Bongrand Hélène Corte Nathan Beaupel Jonathan Catry Jean-Marc Gornet Clotilde Baudry Nelson Lourenco Mariane Maillet My-Linh Tran-Minh Victor Chardiny Joelle Bonnet Leila Chedouba Andrée Nisard Laurent Beaugerie Anne Bourrier Isabelle Nion-Larmurier Julien Kirchgesner Cécilia Landman Elodie Quevrain Loic Brot Najim Chafai Yann Parc Clothilde Debove Magali Svreck Camille Vincent Nathalie Guedj Marianne Ferron Yoram Bouhnik Olivier Corcos Carmen Stefanescu Sarah Khabil Philippe Marteau Xavier Dray Ulrika Chaput Gilles Bommelaer Marion Goutte Jérémie Denizot Nicolas Barnich Dilek Coban Pierre Desreumaux Benjamin Pariente Coralie Sommeville Jean-Louis Dupas Julien Loreau Franck Brazier Denis Chatelain Christophe Attencourt Martine Leconte Gilles Boschetti Bernard Flourié Eddy Cotte Anne-Laure Charlois Peggy Falgon Helena Hadjisavvas Driffa Moussata Marion Chauvenet Sarah Boyer Xavier Hebuterne Nadia Arab Raja Barhoumi Paul Hofmann Sylvain Le Corff Anna Bonnet Laura Beyer-Berjot Harry Sokol
Abstract : Abstract Background and Aims Surgery is performed in 50–70% of Crohn’s disease [CD] patients, and its main risk is surgical site infection [SSI]. The microbiota has been extensively assessed in CD but not as a potential risk factor for septic morbidity. The objective of this study was to assess the impact of the gut microbiota on SSI in CD. Methods We used the multicentric REMIND prospective cohort to identify all patients who experienced SSI after ileocolonic resection for CD, defined as any postoperative local septic complication within 90 days after surgery: wound abscess, intra-abdominal collection, anastomotic leakage or enterocutaneous fistula. The mucosa-associated microbiota of the ileal resection specimen was analysed by 16S gene sequencing in 149 patients. The variable selection and prediction were performed with random forests [R package VSURF] on clinical and microbiotal data. The criterion of performance that we considered was the area under the Receiver Operating Characteristic [ROC] curve [AUC]. Results SSI occurred in 24 patients [16.1%], including 15 patients [10.1%] with major morbidity. There were no significant differences between patients with or without SSI regarding alpha and beta diversity. The top selected variables for the prediction of SSI were all microbiota-related. The maximum AUC [0.796] was obtained with a model including 14 genera, but an AUC of 0.78 had already been obtained with a model including only six genera [Hungatella, Epulopiscium, Fusobacterium, Ruminococcaceae_ucg_009, Actinomyces and Ralstonia]. Conclusion The gut microbiota has the potential to predict SSI after ileocolonic resection for CD. It might play a role in this frequent postoperative complication.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03638385
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Soumis le : mardi 12 avril 2022 - 11:06:07
Dernière modification le : dimanche 1 mai 2022 - 03:18:02

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Clément Julien, Emré Anakok, Xavier Treton, Maria Nachury, Stéphane Nancey, et al.. Impact of the Ileal Microbiota on Surgical Site Infections in Crohn’s Disease: A Nationwide Prospective Cohort. Journal of Crohn's and Colitis, Elsevier - Oxford University Press, 2022, ⟨10.1093/ecco-jcc/jjac026⟩. ⟨hal-03638385⟩

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