Abstract
Plenty of metagenomic studies have suggested possible associations between microbiome composition and colorectal cancer (CRC). However, these techniques are not economic enough for routine use so far. Therefore, we explored the possibility to detect species associated with colorectal cancer by conventional culture from rectal swab. Fifty-two patients newly diagnosed for adenoma/CRC and 52 age-matched controls were recruited and sampled. Rectal swabs were inoculated on several types of plates and incubated appropriately under both aerobic and anaerobic conditions. All colonial morphotypes were subcultured and identified using MALDI-ToF MS. Although no bacterial species was significantly associated with CRC in our study, we surprisingly observed a strong and significant overrepresentation of the yeast Candida albicans in cases (P = 0.0066, odds ratio 5.444 [95% CI 1.449–20.462]). Potential confounding factors were associated neither with CRC (history of CRC in first-degree relatives, a personal history of appendectomy and cholecystectomy, increased BMI (body mass index), and the percentage of males) nor with C. albicans presence (preexisting diabetes and PPI medication) in our cohort. A growing body of evidence supports the view that C. albicans does cause cancer in humans. We hypothesize that presence of C. albicans in the gut may induce or facilitate some part of the sporadic CRC cases. Our observation should be a strong incentive to verify the potential usefulness of the easily culturable C. albicans yeast as a screening marker for patients at risk of CRC or those suffering an early asymptomatic stage of CRC.
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Acknowledgments
The help of Dr. Jana Zapletalová with the statistical analysis is highly appreciated.
Funding
This work was supported by the Faculty of Medicine & Dentistry, Palacký University Olomouc (IGA_LF_2020_021), by the Ministry of Education, Youth and Sports, Czech Republic (DRO 61989592), and by the Ministry of Health, Czech Republic (DRO FNOl 00098892, NV19-03-00069).
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Lubomír Starý and Vladislav Raclavský contributed to the study conception and design. Patients were recruited and clinical data were collected by Lubomír Starý, Kamil Vysloužil, Pavel Zbořil, Pavel Skalický, and Martin Stašek. Kristýna Mezerová and Vladislav Raclavský performed microbiological techniques. Vladislav Raclavský, Lubomír Starý, and Kristýna Mezerová performed data analysis. Vladislav Raclavský wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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All procedures performed were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Ethical committee of the University Hospital Olomouc approved the study on September 15, 2014.
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All participants were informed about the settings of the study and gave informed consent. This article does not contain any studies with animals performed by any of the authors.
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Starý, L., Mezerová, K., Vysloužil, K. et al. Candida albicans culture from a rectal swab can be associated with newly diagnosed colorectal cancer. Folia Microbiol 65, 989–994 (2020). https://doi.org/10.1007/s12223-020-00807-3
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DOI: https://doi.org/10.1007/s12223-020-00807-3