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Impact of the Ileal microbiota on surgical site infections in Crohn’s disease: a nationwide prospective cohort

Clément Julien 1 Emré Anakok 2, 3 Xavier Treton 4 Maria Nachury 5 Stéphane Nancey 6 Anthony Buisson 7, 8 Mathurin Fumery 9, 10 Jérôme Filippi 11 Léon Maggiori 12 Yves Panis 13 Philippe Zerbib 14 Yves François 15 Anne Dubois 16 Charles Sabbagh 17, 18 Amine Rahili 11 Philippe Seksik 3, 19 Matthieu Allez 12 Jérémie Lefevre 20, 19 Pierre Cattan 12 Mircea Chirica 21 Nicolas Munoz-Bongrand 12 Hélène Corte 12 Nathan Beaupel Jonathan Catry Jean-Marc Gornet 12 Clotilde Baudry 12 Nelson Lourenco 12 Mariane Maillet My-Linh Tran-Minh 12 Victor Chardiny Joelle Bonnet Leila Chedouba Andrée Nisard 12 Laurent Beaugerie 22 Anne Bourrier 22 Isabelle Nion-Larmurier Julien Kirchgesner 22 Cécilia Landman 22 Elodie Quevrain Loic Brot Najim Chafai Yann Parc Clothilde Debove Magali Svreck 22 Camille Vincent Nathalie Guedj 23 Marianne Ferron Yoram Bouhnik 23 Olivier Corcos 24 Carmen Stefanescu 23 Sarah Khabil Philippe Marteau 25 Xavier Dray Ulrika Chaput Gilles Bommelaer 16 Marion Goutte 16 Jérémie Denizot 7 Nicolas Barnich 7 Dilek Coban 16 Pierre Desreumaux Benjamin Pariente 26 Coralie Sommeville Jean-Louis Dupas Julien Loreau 27 Franck Brazier 27 Denis Chatelain 28, 27 Christophe Attencourt 27, 28 Martine Leconte Gilles Boschetti 6 Bernard Flourié Eddy Cotte 29 Anne-Laure Charlois Peggy Falgon Helena Hadjisavvas Driffa Moussata Marion Chauvenet 29 Sarah Boyer Xavier Hebuterne 30 Nadia Arab Raja Barhoumi Paul Hofmann Sylvain Le Corff 31, 32 Anna Bonnet 2, 19 Laura Beyer-Berjot 1, 33, 34 Harry Sokol 3, 19, 34 
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 : samedi 10 septembre 2022 - 03:07:14

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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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