Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/10/11/2682 |
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| author | Matthias Kelm Simon Kusan Güzin Surat Friedrich Anger Joachim Reibetanz Christoph-Thomas Germer Nicolas Schlegel Sven Flemming |
| author_facet | Matthias Kelm Simon Kusan Güzin Surat Friedrich Anger Joachim Reibetanz Christoph-Thomas Germer Nicolas Schlegel Sven Flemming |
| author_sort | Matthias Kelm |
| collection | DOAJ |
| description | 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 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 <i>Streptococcus groups</i> and <i>Enterobacterales</i> 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. |
| first_indexed | 2024-03-09T19:15:10Z |
| format | Article |
| id | doaj.art-64c590fdad1148348309f90858d8bd38 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T19:15:10Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-64c590fdad1148348309f90858d8bd382023-11-24T03:49:00ZengMDPI AGBiomedicines2227-90592022-10-011011268210.3390/biomedicines10112682Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic TherapyMatthias Kelm0Simon Kusan1Güzin Surat2Friedrich Anger3Joachim Reibetanz4Christoph-Thomas Germer5Nicolas Schlegel6Sven Flemming7Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyUnit for Infection Control and Antimicrobial Stewardship, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyDepartment of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, 97080 Wuerzburg, GermanyPerianal 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 <i>Streptococcus groups</i> and <i>Enterobacterales</i> 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.https://www.mdpi.com/2227-9059/10/11/2682fistulizing Crohn’s Diseasemicrobial spectrumanorectal abscessperianal fistulas |
| spellingShingle | Matthias Kelm Simon Kusan Güzin Surat Friedrich Anger Joachim Reibetanz Christoph-Thomas Germer Nicolas Schlegel Sven Flemming Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy Biomedicines fistulizing Crohn’s Disease microbial spectrum anorectal abscess perianal fistulas |
| title | Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy |
| title_full | Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy |
| title_fullStr | Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy |
| title_full_unstemmed | Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy |
| title_short | Disease- and Medication-Specific Differences of the Microbial Spectrum in Perianal Fistulizing Crohn’s Disease—Relevant Aspects for Antibiotic Therapy |
| title_sort | disease and medication specific differences of the microbial spectrum in perianal fistulizing crohn s disease relevant aspects for antibiotic therapy |
| topic | fistulizing Crohn’s Disease microbial spectrum anorectal abscess perianal fistulas |
| url | https://www.mdpi.com/2227-9059/10/11/2682 |
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