International Journal of Colorectal Disease

, Volume 33, Issue 2, pp 209–218 | Cite as

The oral microbiome—the relevant reservoir for acute pediatric appendicitis?

  • Carlotta Blod
  • Nadine Schlichting
  • Sara Schülin
  • Anne Suttkus
  • Nicole Peukert
  • Catalina Suzana Stingu
  • Christian Hirsch
  • Wieland Elger
  • Martin Lacher
  • Ulf Bühligen
  • Steffi MayerEmail author
Original Article



The oral microbiome has been related to numerous extra oral diseases. Recent studies detected a high abundance of oral bacteria in inflamed appendices in pediatric patients. To elucidate the role of oral bacteria in acute pediatric appendicitis, we studied the oral and appendiceal microbiome of affected children compared to healthy controls.


Between January and June 2015, 21 children undergoing appendectomy for acute appendicitis and 28 healthy controls were prospectively enrolled in the study. All individuals underwent thorough dental examination and laboratory for inflammatory parameters. Samples of inflamed appendices and the gingival sulcus were taken for 16S rDNA sequencing. RT-qPCR of Fusobacterium nucleatum, Peptostreptococcus stomatis, and Eikenella corrodens was performed and their viability was tested under acidic conditions to mimic gastric transfer.


In phlegmonous appendices, Bacteroidetes and Porphyromonas were discovered as dominant phylum and genus. In sulcus samples, Firmicutes and Streptococcus were detected predominantly. P. stomatis, E. corrodens, and F. nucleatum were identified in each group. Viable amounts of P. stomatis were increased in sulci of children with acute appendicitis compared to sulci of healthy controls. In inflamed appendices, viable amounts of E. corrodens and F. nucleatum were decreased compared to sulci of children with appendicitis. Postprandial viability could be demonstrated for all tested bacteria.


In children with acute appendicitis, we identified several oral bacterial pathogens. Based on postprandial viability of selected species, a viable migration from the oral cavity through the stomach to the appendix seems possible. Thus, the oral cavity could be a relevant reservoir for acute appendicitis.


Oral bacteria Appendix Sequencing Microbiome Peptostreptococcus stomatis 



We are grateful to Marco Ginzel for his excellent theoretical and technical assistance.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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ESM 1 (DOCX 14 kb).
384_2017_2948_MOESM2_ESM.docx (14 kb)
ESM 2 (DOCX 14 kb).
384_2017_2948_MOESM3_ESM.docx (17 kb)
ESM 3 (DOCX 17.4 kb).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Carlotta Blod
    • 1
  • Nadine Schlichting
    • 1
    • 2
  • Sara Schülin
    • 1
  • Anne Suttkus
    • 1
  • Nicole Peukert
    • 1
  • Catalina Suzana Stingu
    • 3
  • Christian Hirsch
    • 4
  • Wieland Elger
    • 4
  • Martin Lacher
    • 1
  • Ulf Bühligen
    • 1
  • Steffi Mayer
    • 1
    Email author
  1. 1.Department of Pediatric SurgeryUniversity of LeipzigLeipzigGermany
  2. 2.Experimental surgery/CardiOMICs research group, Department of Diagnostics and New TechnologiesFraunhofer Institute for Cell Therapy and Immunology (IZI)LeipzigGermany
  3. 3.Institute for Medical Microbiology and Epidemiology of Infectious DiseasesUniversity of LeipzigLeipzigGermany
  4. 4.Department of Pediatric Dentistry and Primary PreventionUniversity of LeipzigLeipzigGermany

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