EP924 - Oral Streptococcus Drives Fecal Streptococcus Colonization following Colon Resection

ePoster Presenter(s)

• 

  Julia Frebault, MD (she/her/hers)

  General Surgery Research Resident
  University of Minnesota
  University of Minnesota
  Minneapolis, MN, United States

  Disclosure information not submitted.

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Author(s)

• CB

  Catherine Beauharnais, MD, MPH, MS

  Fellow
  University of Minnesota
  University of Minnesota
  Minneapolis, MN, United States

  Disclosure information not submitted.
• MH

  Max G. Hill, BS

  Research Assistant
  UMN Department of Surgery
  St. Paul, Minnesota, United States

  Disclosure information not submitted.
• 

  Alexander M. Troester, MD (he/him/his)

  General Surgery Resident
  University of Minnesota
  University of Minnesota
  Minneapolis, MN, United States

  Disclosure information not submitted.
• SB

  Sonja Boatman, MD (she/her/hers)

  Resident
  Universit of Minnesota
  University of Minnesota
  Minneapolis, MN, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
• 

  Paolo Goffredo, MD (he/him/his)

  Assistant Professor
  University of Minnesota
  Minneapolis, MN, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
• 

  Wolfgang Gaertner, MD, MSc, MBA

  Professor and Chief, Colon & Rectal Surgery
  University of Minnesota
  University of Minnesota
  Minneapolis, MN, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.
• CS

  Christopher Staley, n/a

  Associate Professor
  University of Minnesota
  Minneapolis, Minnesota, United States

  Disclosure information not submitted.

Senior Author(s)

• 

  Cyrus Jahansouz, MD

  Assistant Professor
  University of Minnesota
  University of Minnesota
  Minneapolis, Minnesota, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Purpose/Background: The intestinal microbiota is known to be disrupted following surgical bowel preparation (SBP), a combination of antibiotics and mechanical bowel preparation (MBP) utilized prior to colorectal surgery. In particular, a steep rise in the relative abundance of Streptococcus species following SBP and lasting through the postoperative period has been identified and linked to post-operative complications including anastomotic leak. Through the oral-gut microbiome axis, the oral cavity may be a source of translocation and colonization of the gut following this disruption of the intestinal microbiota. This study examines the oral microbiome as a potential source of gut bacterial re-population following SBP in patients undergoing colon surgery.

Methods/Interventions: Fecal and saliva samples from patients undergoing colon resection (SBP, n=5) were obtained at five timepoints: pre-operative, day of surgery (DOS), postoperative day 10 (POD10), POD30, and POD180. Samples were also obtained from a control group of patients who underwent colonoscopy (MBP, n=7) at the same timepoints. Microbial composition was assessed with 16S rRNA sequencing and compared between the two groups. Alpha and beta diversity were analyzed using mothur software. SourceTracker assessed similarity between fecal and oral samples.

Results/Outcomes: Microbial diversity, assessed by Shannon Index, differed significantly between surgical and control patients on the day of procedure through POD10 in saliva samples (P=0.003 and 0.05, respectively), and at POD10 in fecal samples (P=0.022). Prevotella and Streptococcus were abundant in all saliva samples, with higher relative abundance of Streptococcus in surgical patients (Figure 1A). Fecal samples demonstrated a rise in Streptococcus species in the surgical group on the day of surgery, persisting through POD10 (Figure 1B). Surgical fecal samples maintained increased similarity to saliva samples compared to controls on DOS, persisting through POD10 (Figure 1C, P=0.29 and 0.04 respectively).

Conclusion/Discussion: In this exploratory analysis examining the role of the oral-gut axis, patients who underwent SBP and colon resection demonstrated a rise in Streptococcus species compared to controls, mirroring the composition of the saliva. The oral microbiome appears to play a significant role in repopulation of gut microbiota following disruption due to SBP and colon resection.

Figure 1
A) Relative abundance of predominant taxa in saliva samples in control and surgical patients at baseline, day of procedure (DOS), and postoperative day (POD) 10, 30, and 180. B) Relative abundance of predominant taxa in stool samples in control and surgical patients at the same timepoints. C) Similarity of stool samples of control and surgical patients compared to saliva samples of each cohort.