A Novel Nonantibiotic Gut-directed Strategy to Prevent Surgical Site Infections

Area of Science:

• Microbiology
• Immunology
• Polymer Science

Background:

• Gut microbiota dysbiosis and antibiotic use can lead to postoperative infections via the "Trojan Horse" mechanism.
• Pathogens from the gut can silently travel within immune cells to contaminate surgical sites.

Purpose of the Study:

• To evaluate the efficacy of orally delivered phosphate-rich polymer, Pi-PEG, in preventing surgical site infections (SSIs).
• To test Pi-PEG in a novel mouse model of spontaneous wound infection involving gut-derived pathogens.

Main Methods:

• Mice were fed either a standard or western-type diet and exposed to antibiotics.
• Pi-PEG was administered in drinking water to assess its impact on SSI incidence.
• Gut and wound microbiome composition was analyzed using amplicon sequence variant analysis.

Main Results:

• A western-type diet and antibiotic exposure promoted SSI pathogen growth in the gut and wound.
• Pi-PEG administration protected mice against SSIs.
• Protection was linked to modulation of the gut-wound microbiome.

Conclusions:

• Orally administered Pi-PEG prevents SSIs in a mouse model.
• Pi-PEG represents a sustainable, non-antibiotic strategy for surgical infection prevention.
• This approach may reduce reliance on increased sterility and broad-spectrum antibiotics.