Journal article
Identification of Collagenolytic Bacteria in Human Samples: Screening Methods and Clinical Implications for Resolving and Preventing Anastomotic Leaks and Wound Complications
Diseases of the colon & rectum, Vol.62(8), pp.972-979
08/2019
DOI: 10.1097/DCR.0000000000001417
PMCID: PMC6624086
PMID: 31283593
Abstract
Bacteria that produce collagen-digesting enzymes (collagenolytic bacteria) have been shown to play a critical and previously unappreciated role in anastomotic leak pathogenesis by breaking down host tissue extracellular matrix proteins. Detection of these bacteria is labor intensive, and no screening method currently exists.
We evaluated a rapid screening method developed to detect the presence of these collagenolytic bacteria in clinical samples, such as drain fluid, anastomotic tissue, or feces.
We compared a new method of detecting collagenolytic bacterial species with a previously used technique using samples from a murine experimental model and then demonstrated the utility of this screening method in samples from patients with anastomotic complications.
All of the laboratory work and previous murine experiments were performed in Dr Alverdy's laboratory at the University of Chicago under institutional review board-approved protocols.
Samples from patients with challenging wound complications were provided by participating clinicians with verbal patient consent. Given the small number of patients, this was determined to be institutional review board exempt.
Whether this analysis can influence patient management and outcomes will require additional study.
This screening method detects numerous strains of bacteria with collagenolytic properties, including the collagenolytic species that have been implicated previously in anastomotic leak. Once collagenolytic strains are identified, they can be speciated and tested for antibiotic resistance using standard laboratory techniques.
This study is limited by the small number of patient samples tested.
We demonstrated the potential applicability of this assay to evaluate rare and complex anastomotic complications that often require analysis beyond standard culture and sensitivity assays. Future applications of this method may allow the development of strategies to prevent anastomotic leak related to collagenolytic bacteria. See Video Abstract at http://links.lww.com/DCR/A962.
Details
- Title: Subtitle
- Identification of Collagenolytic Bacteria in Human Samples: Screening Methods and Clinical Implications for Resolving and Preventing Anastomotic Leaks and Wound Complications
- Creators
- Kristina L Guyton - Department of Surgery, University of Chicago, Chicago, IllinoisZoe C Levine - Department of Surgery, University of Chicago, Chicago, IllinoisAnn C Lowry - Colon and Rectal Surgery Associates, University of Minnesota, Minneapolis, MinnesotaLaura Lambert - Section of Surgical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UtahIrena Gribovskaja-Rupp - University of Iowa Hospitals and Clinics, Iowa City, IowaNeil Hyman - Department of Surgery, University of Chicago, Chicago, IllinoisOlga Zaborina - Department of Surgery, University of Chicago, Chicago, IllinoisJohn Alverdy - Department of Surgery, University of Chicago, Chicago, Illinois
- Resource Type
- Journal article
- Publication Details
- Diseases of the colon & rectum, Vol.62(8), pp.972-979
- DOI
- 10.1097/DCR.0000000000001417
- PMID
- 31283593
- PMCID
- PMC6624086
- NLM abbreviation
- Dis Colon Rectum
- ISSN
- 0012-3706
- eISSN
- 1530-0358
- Publisher
- United States
- Grant note
- R34 GM111550 / NIGMS NIH HHS R01 GM062344 / NIGMS NIH HHS
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Surgery
- Record Identifier
- 9984051793902771
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