Related Experiment Video
Updated: Sep 3, 2025
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Microbial Spectrum and Antibiotic Resistance in Patients Suffering from Penetrating Crohn's Disease
Simon Kusan1, Güzin Surat2, Matthias Kelm1
1Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, Center of Operative Medicine (ZOM), University Hospital of Wuerzburg, 97080 Wuerzburg, Germany.
Abstract:
Intraabdominal abscess formation occurs in up to 30% of patients suffering from Crohn´s disease (CD). While international guidelines recommend a step-up approach with a combination of empiric antibiotic therapy and percutaneous drainage to delay or even avoid surgery, evidence about microbial spectrum in penetrating ileitis is sparse. We retrospectively assessed outcomes of 46 patients with terminal penetrating Ileitis where microbial diagnostics have been performed and compared microbial spectrum and antibiotic resistance profile of CD patients with patients suffering from diverticulitis with intraabdominal abscess formation. In both groups, the most frequently isolated pathogen was the gram-negative bacterium E.coli belonging to the family of Enterobacterales. However, overall Enterobacterales were significantly more often verifiable in the control group than in CD patients. Furthermore, microbial analysis showed significant differences regarding isolation of anaerobic pathogens with decreased frequency in patients with CD. Subgroup analysis of CD patients to evaluate a potential influence of immunosuppressive therapy on microbial spectrum only revealed that Enterobacterales was less frequently detected in patients treated with steroids. Immunosuppressive therapy did not show any impact on all other groups of pathogens and did not change antibiotic resistance profile of CD patients. In conclusion, we were able to demonstrate that the microbial spectrum of CD patients does differ only for some pathogen species without increased rate of antibiotic resistance. However, the empiric antibiotic therapy for CD-associated intra-abdominal abscess remains challenging since different points such as local epidemiological and microbiological data, individual patient risk factors, severity of infection, and therapy algorithm including non-surgical and surgical therapy options should be considered before therapeutical decisions are made.
Insights
Intra-abdominal abscesses in Crohn's disease (CD) patients show a different microbial spectrum compared to diverticulitis, with fewer anaerobic pathogens. Antibiotic resistance is not increased in CD patients, but therapy remains complex.
Area of Science:
- Gastroenterology
- Microbiology
- Infectious Diseases
Background:
- Intra-abdominal abscesses complicate up to 30% of Crohn's disease (CD) cases.
- Current guidelines favor a step-up approach involving antibiotics and drainage, but microbial data in penetrating ileitis are limited.
Purpose of the Study:
- To compare the microbial spectrum and antibiotic resistance profiles of intra-abdominal abscesses in CD patients with those in diverticulitis patients.
- To assess the impact of immunosuppressive therapy on microbial composition in CD-associated abscesses.
Main Methods:
- Retrospective analysis of 46 CD patients with terminal penetrating ileitis who underwent microbial diagnostics.
- Comparison of microbial findings with a control group of diverticulitis patients with intra-abdominal abscesses.
Main Results:
- Escherichia coli was the most common pathogen in both groups, but Enterobacterales were less frequent in CD patients.
- Anaerobic pathogens were significantly less common in CD patients compared to diverticulitis patients.
- Steroid use in CD patients was associated with lower detection rates of Enterobacterales, but overall antibiotic resistance was not increased.
Conclusions:
- The microbial spectrum in CD-associated intra-abdominal abscesses differs from diverticulitis, particularly regarding anaerobic pathogens.
- Despite no increased antibiotic resistance, empiric antibiotic therapy for CD abscesses is challenging and requires consideration of multiple factors.
More Related Videos
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
07:16Development of a Polymicrobial Colony Biofilm Model to Test Antimicrobials in Cystic Fibrosis
Published on: September 20, 2024
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:30Development of Antibiotic Resistance
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids