Disease- and medication-specific differences of the microbial spectrum in perianal fistulizing Crohn’s Disease — relevant aspects for antibiotic therapy

Please always quote using this URN: urn:nbn:de:bvb:20-opus-290281
  • Perianal fistulizing Crohn’s Disease (CD) with abscess formation represents an aggressive phenotype in Inflammatory Bowel Disease (IBD) with increased morbidity. Treatment is multidisciplinary and includes antibiotics, but knowledge about the microbial spectrum is rare often resulting in inadequate antimicrobial therapy. In this single center retrospective study, all patients who were operated due to perianal abscess formation were retrospectively analyzed and the microbial spectrum evaluated. Patients were divided into a CD and non-CD groupPerianal fistulizing Crohn’s Disease (CD) with abscess formation represents an aggressive phenotype in Inflammatory Bowel Disease (IBD) with increased morbidity. Treatment is multidisciplinary and includes antibiotics, but knowledge about the microbial spectrum is rare often resulting in inadequate antimicrobial therapy. In this single center retrospective study, all patients who were operated due to perianal abscess formation were retrospectively analyzed and the microbial spectrum evaluated. Patients were divided into a CD and non-CD group with further subgroup analysis. 138 patients were finally included in the analysis with 62 patients suffering from CD. Relevant differences were detected for the microbial spectrum with anaerobic bacteria being significantly more often isolated from non-CD patients. In a subgroup-analysis of CD patients only, medical therapy had a relevant effect on the microbial spectrum since Streptococcus groups and Enterobacterales were significantly more often isolated in patients treated with steroids compared to those being treated by antibodies. In conclusion, the microbial spectrum of patients suffering from CD varies significantly from non-CD patients and immunosuppressive medication has a relevant effect on isolated pathogens. Based on that, adaption of antibiotic treatment might be discussed in the future.show moreshow less

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Metadaten
Author: Matthias Kelm, Simon Kusan, Güzin Surat, Friedrich Anger, Joachim Reibetanz, Christoph-Thomas Germer, Nicolas Schlegel, Sven Flemming
URN:urn:nbn:de:bvb:20-opus-290281
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I)
Language:English
Parent Title (English):Biomedicines
ISSN:2227-9059
Year of Completion:2022
Volume:10
Issue:11
Article Number:2682
Source:Biomedicines (2022) 10:11, 2682. https://doi.org/10.3390/biomedicines10112682
DOI:https://doi.org/10.3390/biomedicines10112682
Sonstige beteiligte Institutionen:Krankenhaushygiene und Antimicrobial Stewardship (Universitätsklinikum)
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:anorectal abscess; fistulizing Crohn’s Disease; microbial spectrum; perianal fistulas
Release Date:2023/10/05
Date of first Publication:2022/10/23
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International