Ling YT, Yao F, Li SJ, Cao CX, Chen ZW, Qiu M, Li BZ, Hu BW, Zhong SY, Hu GL, Li JH. Microbiota in patients with cefuroxime resistance and anal fistula revealed by 16S ribosomal DNA. World J Gastrointest Surg 2025; 17(1): 100790 [DOI: 10.4240/wjgs.v17.i1.100790]
Corresponding Author of This Article
Fei Yao, MD, Department of Anorectal Surgery, The Second Affiliated Hospital of Jiaxing University, No. 397 North Huancheng Road, Nanhu District, Jiaxing 314000, Zhejiang Province, China. yaof890726@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yi-Ting Ling, Fei Yao, Sen-Juan Li, Chen-Xi Cao, Zhen-Wei Chen, Min Qiu, Bu-Zhuo Li, Bi-Wen Hu, Shen-Yan Zhong, Guang-Lei Hu, Jia-Hua Li, Department of Anorectal Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Ling YT and Yao F designed the research study; Ling YT, Li SJ, Cao CX, and Chen ZW performed the research; Qiu M, Hu GL, and Li JH contributed new reagents and analytic tools; Ling YT, Li BZ, Hu BW, and Yao F analyzed the data and wrote the manuscript; Zhong SY debugged the code and organized the visualization results; and all authors have read and approved the final manuscript.
Supported by the Jiaxing Science and Technology Project, No. 2023AD11016 and No. 2023AD31028.
Institutional review board statement: This study was reviewed and approved by the Medical Ethics Committee of the Second Affiliated Hospital of Jiaxing University, approval Jiaxing Second Hospital Ethics Review, No. 2023-028.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Yao, MD, Department of Anorectal Surgery, The Second Affiliated Hospital of Jiaxing University, No. 397 North Huancheng Road, Nanhu District, Jiaxing 314000, Zhejiang Province, China. yaof890726@163.com
Received: September 6, 2024 Revised: October 11, 2024 Accepted: November 18, 2024 Published online: January 27, 2025 Processing time: 112 Days and 5.9 Hours
Abstract
BACKGROUND
Anal fistula is increasingly prevalent due to modern lifestyle factors, and surgery remains the primary treatment. However, the rising incidence of antibiotic resistance, particularly to cefuroxime, complicates perioperative management. The role of gut microbiota in influencing this resistance is not well understood.
AIM
To investigate the relationship between gut microbiota composition and cefuroxime resistance in anal fistula patients and to assess probiotic intervention impact.
METHODS
This study included 30 anal fistula patients categorized into cefuroxime-sensitive (Cefur-S) and cefuroxime-resistant (Cefur-NS) groups. Gut microbiota samples were collected during colonoscopy, and 16S ribosomal DNA sequencing was performed to analyze microbial diversity. Patients in the Cefur-NS group received a 7-day course of Clostridium butyricum tablets. Post-intervention, microbial composition and cefuroxime resistance were reassessed.
RESULTS
Alpha and beta diversity analyses showed no significant differences in microbial diversity between the Cefur-S and Cefur-NS groups. However, effect size analysis identified Roseburia and Butyricicoccus as dominant genera in the Cefur-S group, with higher butyrate production potentially protecting against cefuroxime resistance. Post-intervention, the Cefur-NS group showed a significant reduction in cefuroxime resistance, improved stool consistency, and reduced bowel movement frequency.
CONCLUSION
This study suggests that specific gut microbiota, particularly Butyricicoccus and Roseburia, may mitigate cefuroxime resistance in anal fistula patients by increasing butyrate production. Probiotic intervention targeting gut microbiota composition presents a promising strategy for reducing antibiotic resistance and improving clinical outcomes.
Core Tip: This study explores the role of gut microbiota in cefuroxime resistance among anal fistula patients, highlighting the protective effects of butyrate-producing bacteria such as Butyricicoccus and Roseburia. The findings demonstrate that modulating gut microbiota through probiotic intervention can significantly reduce cefuroxime resistance, improve stool consistency, and lower bowel movement frequency. This research offers valuable insights into the potential of microbiota-based strategies to manage antibiotic resistance and enhance perioperative care in anal fistula patients.
