Dataset Information

Distinct changes in the colonic microbiome associated with acute diverticulitis.

ABSTRACT:

Aim

The pathogenesis of acute diverticulitis (AD) remains incompletely understood, despite it being one of the most common gastrointestinal conditions worldwide. The aim of this study was to investigate the role of the colonic microbiome in the pathogenesis of AD.

Method

A prospective case-control study was performed, comparing the microbiome of AD patients with that of controls, using 16S rRNA sequencing of rectal swab samples.

Results

The microbiome of individuals with AD showed lower diversity than that of controls. There were significant compositional differences observed, with a lower abundance of commensal bacterial families and genera such as Lachnospiraceae, Ruminococcus and Faecalibacterium in AD patients compared with controls, and there was an increase in several genera with known pathogenic roles including Fusobacteria, Prevotella and Paraprevotella.

Conclusion

This is the largest study to date to examine the microbiota of AD patients, and adds evidence to the proposed hypothesis that alterations in the colonic microbiome play a role in the pathogenesis of AD.

SUBMITTER: Mj O

PROVIDER: S-EPMC10087140 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Distinct changes in the colonic microbiome associated with acute diverticulitis.

Mj O'Grady O Turner Greg A GA A Sulit S Frizelle Frank A FA R Purcell P

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 20220811 12

<h4>Aim</h4>The pathogenesis of acute diverticulitis (AD) remains incompletely understood, despite it being one of the most common gastrointestinal conditions worldwide. The aim of this study was to investigate the role of the colonic microbiome in the pathogenesis of AD.<h4>Method</h4>A prospective case-control study was performed, comparing the microbiome of AD patients with that of controls, using 16S rRNA sequencing of rectal swab samples.<h4>Results</h4>The microbiome of individuals with AD ...[more]

PMID: 35950499

Similar Datasets

Project description:BackgroundAcute colonic diverticulitis (ACD) complications arise in approximately 8% to 35% patients and the most common ones are represented by phlegmon or abscess, followed by perforation, peritonitis, obstruction, and fistula. In accordance with current guidelines, patients affected by generalized peritonitis should undergo emergency surgery. However, decisions on whether and when to operate ACD patients remain a substantially debated topic while algorithm for the best treatment has not yet been determined. Damage control surgery (DCS) represents a well-established method in treating critically ill patients with traumatic abdomen injuries. At present, such surgical approach is also finding application in non-traumatic emergencies such as perforated ACD. Thanks to a thorough systematic review of the literature, we aimed at achieving deeper knowledge of both indications and short- and long-term outcomes related to DCS in perforated ACD.MethodsWe performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Pubmed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science databases were used to search all related literature.ResultsThe 8 included articles covered an approximately 13 years study period (2006-2018), with a total 359 patient population. At presentation, most patients showed III and IV American Society of Anesthesiologists (ASA) score (81.6%) while having Hinchey III perforated ACD (69.9%). Most patients received a limited resection plus vacuum-assisted closure at first-look while about half entire population underwent primary resection anastomosis (PRA) at a second-look. Overall morbidity rate, 30-day mortality rate and overall mortality rate at follow-up were between 23% and 74%, 0% and 20%, 7% and 33%, respectively. Patients had a 100% definitive abdominal wall closure rate and a definitive stoma rate at follow-up ranging between 0% and 33%.ConclusionDCS application to ACD patients seems to offer good outcomes with a lower percentage of patients with definitive ostomy, if compared to Hartmann's procedure. However, correct definition of DCS eligible patients is paramount in avoiding overtreatment. In accordance to 2016 WSES (World Society of Emergency Surgery) Guidelines, DCS remains an effective surgical strategy in critically ill patients affected by sepsis/septic shock and hemodynamical unstability.

Project description:BackgroundAcute diverticulitis is commonly misdiagnosed among patients with acute abdominal pain in the emergency department (ED). There are predictive scores that assist in the diagnosis of acute left-sided diverticulitis, but no scoring system is available for diagnosing acute diverticulitis without regard to the affected side. Therefore, developing a predictive score for diagnosing acute diverticulitis that is not limited to the left side will guide physicians in making a diagnosis and increase the appropriateness of computed tomography. This study aimed to establish a predictive score for diagnosing acute diverticulitis.MethodThis single-centre retrospective study included adult patients (≥ 18 years) who presented to the ED with acute abdominal pain. Multivariate logistic regression analysis was used to identify essential factors for diagnosing acute diverticulitis, and the Akaike information criterion was calculated to identify significant predictive factors for diagnosing acute diverticulitis using a clinical scoring system.ResultsOf 424 patients who fulfilled the inclusion criteria, 72 (17%) were diagnosed with acute diverticulitis. The significant factors associated with acute diverticulitis were age ≥ 60 years (adjusted odds ratio (adj.OR) 2.23, 95% confidence interval (CI): 1.20 - 4.14, p = 0.01), duration of abdominal pain ≥ 48 h (adj.OR 2.64, 95% CI: 1.28 - 5.45, p = 0.017), history of a diverticulum (adj.OR 7.77, 95% CI: 3.27 - 18.45, p < 0.001), absence of nausea and vomiting (adj.OR 3.42, 95% CI: 1.65 - 7.10, p < 0.001), absence of anorexia (adj.OR 3.33, 95% CI: 1.34 - 8.33, p = 0.026), absence of tachycardia (adj.OR 3.51, 95% CI: 1.39 - 8.87, p = 0.003), and abdominal guarding (adj.OR 2.99, 95% CI: 1.52 - 5.91, p = 0.002). These predictive factors were converted into predictive scores for diagnosing acute diverticulitis. For the score of ≥ 4, the sensitivity and specificity were 73.24% (95% CI: 0.61-0.83) and 80.40% (95% CI: 0.76-0.84), respectively, and the negative predictive value was 93.71% (95% CI: 0.90-0.96). No significant signs, symptoms, or laboratory findings were associated with complicated diverticulitis.ConclusionPredictive factors for diagnosing acute diverticulitis included age ≥ 60 years, duration of abdominal pain ≥ 48 h, history of a diverticulum, abdominal guarding, and absence of nausea and vomiting, anorexia, and tachycardia. A predictive score ≥ 4 suggested the presence of acute diverticulitis.

Dataset Information

Distinct changes in the colonic microbiome associated with acute diverticulitis.

Aim

Method

Results

Conclusion

Publications

Distinct changes in the colonic microbiome associated with acute diverticulitis.

Similar Datasets

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