The oral microbiome—the relevant reservoir for acute pediatric appendicitis?
- 359 Downloads
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.
KeywordsOral bacteria Appendix Sequencing Microbiome Peptostreptococcus stomatis
We are grateful to Marco Ginzel for his excellent theoretical and technical assistance.
Compliance with ethical standards
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 was obtained from all individual participants included in the study.
- 2.Swidsinski A, Dorffel Y, Loening-Baucke V, Theissig F, Ruckert JC, Ismail M, Rau WA, Gaschler D, Weizenegger M, Kuhn S, Schilling J, Dorffel WV (2011) Acute appendicitis is characterised by local invasion with Fusobacterium nucleatum/necrophorum. Gut 60(1):34–40. https://doi.org/10.1136/gut.2009.191320 CrossRefPubMedGoogle Scholar
- 3.Jackson HT, Mongodin EF, Davenport KP, Fraser CM, Sandler AD, Zeichner SL (2014) Culture-independent evaluation of the appendix and rectum microbiomes in children with and without appendicitis. PLoS One 9(4):e95414. https://doi.org/10.1371/journal.pone.0095414 CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Swidsinski A, Dorffel Y, Loening-Baucke V, Tertychnyy A, Biche-Ool S, Stonogin S, Guo Y, Sun ND (2012) Mucosal invasion by Fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China. Saudi J Gastroenterol 18(1):55–58. https://doi.org/10.4103/1319-3767.91734 CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Guinane CM, Tadrous A, Fouhy F, Ryan CA, Dempsey EM, Murphy B, Andrews E, Cotter PD, Stanton C, Ross RP (2013) Microbial composition of human appendices from patients following appendectomy. MBio 4(1). https://doi.org/10.1128/mBio.00366-12
- 14.Frohlich GM, Schoch B, Wolfrum M, Osranek M, Enseleit F, Herzog BA, Hasun M, Luscher TF, Meier P, Gaemperli O, Kaufmann PA, Corti R (2014) The impact of modern noninvasive cardiac imaging on coronary intervention rates. J Interv Cardiol 27(1):50–57. https://doi.org/10.1111/joic.12079 CrossRefPubMedGoogle Scholar
- 15.Lacher M, Muensterer OJ, Yannam GR, Aprahamian CJ, Perger L, Megison M, DC Y, Beierle EA, Anderson SA, Chen MK, Harmon CM (2012) Feasibility of single-incision pediatric endosurgery for treatment of appendicitis in 415 children. J Laparoendosc Adv Surg Tech A 22(6):604–608. https://doi.org/10.1089/lap.2012.0107 CrossRefPubMedGoogle Scholar
- 17.Schaumann S, Staufenbiel I, Scherer R, Schilhabel M, Winkel A, Stumpp SN, Eberhard J, Stiesch M (2014) Pyrosequencing of supra- and subgingival biofilms from inflamed peri-implant and periodontal sites. BMC oral health 14(1):157. https://doi.org/10.1186/1472-6831-14-157 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Angly FE, Dennis PG, Skarshewski A, Vanwonterghem I, Hugenholtz P, Tyson GW (2014) CopyRighter: a rapid tool for improving the accuracy of microbial community profiles through lineage-specific gene copy number correction. Microbiome 2(1):11. https://doi.org/10.1186/2049-2618-2-11 CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Caporaso JG, Kuczynski J, Stombaugh J, Bittinger K, Bushman FD, Costello EK, Fierer N, Pena AG, Goodrich JK, Gordon JI, Huttley GA, Kelley ST, Knights D, Koenig JE, Ley RE, Lozupone CA, McDonald D, Muegge BD, Pirrung M, Reeder J, Sevinsky JR, Turnbaugh PJ, Walters WA, Widmann J, Yatsunenko T, Zaneveld J, Knight R (2010) QIIME allows analysis of high-throughput community sequencing data. Nat Methods 7(5):335–336. https://doi.org/10.1038/nmeth.f.303 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Yuk HG, Jo SC, Seo HK, Park SM, Lee SC (2008) Effect of storage in juice with or without pulp and/or calcium lactate on the subsequent survival of Escherichia coli O157:H7 in simulated gastric fluid. Int J Food Microbiol 123(3):198–203. https://doi.org/10.1016/j.ijfoodmicro.2008.01.013 CrossRefPubMedGoogle Scholar
- 29.Kononen E, Bryk A, Niemi P, Kanervo-Nordstrom A (2007) Antimicrobial susceptibilities of Peptostreptococcus anaerobius and the newly described Peptostreptococcus stomatis isolated from various human sources. Antimicrob Agents Chemother 51(6):2205–2207. https://doi.org/10.1128/aac.00056-07 CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Cao H, Qi Z, Jiang H, Zhao J, Liu Z, Tang Z (2012) Detection of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia in primary endodontic infections in a Chinese population. Int Endod J 45(8):773–781. https://doi.org/10.1111/j.1365-2591.2012.02035.x CrossRefPubMedGoogle Scholar
- 32.Lombardo Bedran TB, Marcantonio RA, Spin Neto R, Alves Mayer MP, Grenier D, Spolidorio LC, Spolidorio DP (2012) Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study. J Oral Microbiol 4(1). https://doi.org/10.3402/jom.v4i0.10123
- 40.Gonzalvez Pinera J, Marco Macian A, Perez Martinez A, Escriban (1995) [Intra-abdominal infections caused by Eikenella corrodens in children]. Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica 8 (4):145–147Google Scholar