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Intestinal microbial diversity and perioperative complications

Matthew W Ralls1, Eiichi Miyasaka, Daniel H Teitelbaum

  • 1Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.

JPEN. Journal of Parenteral and Enteral Nutrition
|May 3, 2013
PubMed
Abstract

Insights

Parenteral nutrition (PN) in humans significantly reduces small bowel microbial diversity, increasing risks of enteric infections and anastomotic disruptions. This highlights the critical role of the gut microbiome in maintaining intestinal health during nutrient deprivation.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Surgical Research

Background:

  • Enteral nutrient deprivation via parenteral nutrition (PN) induces inflammation, barrier dysfunction, and atrophy in mouse models.
  • PN impacts the intestinal microbiome, but its effects on the human microbiome during nutrient deprivation are unknown.

Purpose of the Study:

  • To investigate whether enteral nutrient deprivation in humans causes similar shifts in the intestinal microbiome as observed in mice.
  • To explore the association between changes in the small bowel microbiome and postoperative complications.

Main Methods:

  • Analysis of mucosally associated bacteria from small bowel specimens of pediatric and adult patients undergoing resection.
  • Utilized 454 pyrosequencing to assess microbial diversity and characteristics in enterally fed versus deprived segments.
  • Examined the occurrence of postoperative infectious and anastomotic complications.

Main Results:

  • Pyrosequencing revealed significant microbial diversity variability across all patient groups.
  • Microbial communities showed only partial stratification between enterally fed and deprived intestinal segments.
  • A strong correlation was found between low enteric microbial diversity and the development of postoperative enteric infections or anastomotic disruption.

Conclusions:

  • Loss of enteral nutrients and systemic antibiotics in humans leads to a significant reduction in small bowel mucosal microbial biodiversity.
  • These microbial shifts are associated with increased risks of enteric infections and intestinal anastomotic disruptions.
Keywords:
intestinemicrobiotamicrofloraparenteral nutrition

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