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Di Carlo P, Serra N, Fasciana TMA, Giammanco A, D’Arpa F, Rea T, Napolitano MS, Lucchesi A, Cascio A, Sergi CM. Microbial profile in bile from pancreatic and extra-pancreatic biliary tract cancer. PLoS One 2024; 19:e0294049. [PMID: 38381746 PMCID: PMC10880987 DOI: 10.1371/journal.pone.0294049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/11/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Dysbiotic biliary bacterial profile is reported in cancer patients and is associated with survival and comorbidities, raising the question of its effect on the influence of anticancer drugs and, recently, the suggestion of perichemotherapy antibiotics in pancreatic cancer patients colonized by the Escherichia coli and Klebsiella pneumoniae. OBJECTIVE In this study, we investigated the microbial communities that colonize tumours and which bacteria could aid in diagnosing pancreatic and biliary cancer and managing bile-colonized patients. METHODS A retrospective study on positive bile cultures of 145 Italian patients who underwent cholangiopancreatography with PC and EPC cancer hospitalized from January 2006 to December 2020 in a QA-certified academic surgical unit were investigated for aerobic/facultative-anaerobic bacteria and fungal organisms. RESULTS We found that among Gram-negative bacteria, Escherichia coli and Pseudomonas spp were the most frequent in the EPC group, while Escherichia coli, Klebsiella spp, and Pseudomonas spp were the most frequent in the PC group. Enterococcus spp was the most frequent Gram-positive bacteria in both groups. Comparing the EPC and PC, we found a significant presence of patients with greater age in the PC compared to the EPC group. Regarding Candida spp, we found no significant but greater rate in the PC group compared to the EPC group (11.7% vs 1.96%). We found that Alcaligenes faecalis was the most frequent bacteria in EPC than the PC group, among Gram-negative bacterial species. CONCLUSIONS Age differences in gut microbiota composition may affect biliary habitats in our cancer population, especially in patients with pancreatic cancer. Alcaligenes faecalis isolated in the culture of bile samples could represent potential microbial markers for a restricted follow-up to early diagnosis of extra-pancreatic cancer. Finally, the prevalence of Candida spp in pancreatic cancer seems to trigger new aspects about debate about the role of fungal microbiota into their relationship with pancreatic cancer.
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Affiliation(s)
- Paola Di Carlo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Teresa Maria Assunta Fasciana
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Anna Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Francesco D’Arpa
- Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Maria Santa Napolitano
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Alessandro Lucchesi
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) “Dini Amadori”, Meldola, Forl-Cesena, Italy
| | - Antonio Cascio
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D’Alessandro”, Infectious Disease Unit, University of Palermo, Palermo, Italy
| | - Consolato Maria Sergi
- Lab. Med. and Pathology, Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada
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Di Carlo P, Serra N, Alduina R, Guarino R, Craxì A, Giammanco A, Fasciana T, Cascio A, Sergi CM. A systematic review on omics data (metagenomics, metatranscriptomics, and metabolomics) in the role of microbiome in gallbladder disease. Front Physiol 2022; 13:888233. [PMID: 36111147 PMCID: PMC9468903 DOI: 10.3389/fphys.2022.888233] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Microbiotas are the range of microorganisms (mainly bacteria and fungi) colonizing multicellular, macroscopic organisms. They are crucial for several metabolic functions affecting the health of the host. However, difficulties hamper the investigation of microbiota composition in cultivating microorganisms in standard growth media. For this reason, our knowledge of microbiota can benefit from the analysis of microbial macromolecules (DNA, transcripts, proteins, or by-products) present in various samples collected from the host. Various omics technologies are used to obtain different data. Metagenomics provides a taxonomical profile of the sample. It can also be used to obtain potential functional information. At the same time, metatranscriptomics can characterize members of a microbiome responsible for specific functions and elucidate genes that drive the microbiotas relationship with its host. Thus, while microbiota refers to microorganisms living in a determined environment (taxonomy of microorganisms identified), microbiome refers to the microorganisms and their genes living in a determined environment and, of course, metagenomics focuses on the genes and collective functions of identified microorganisms. Metabolomics completes this framework by determining the metabolite fluxes and the products released into the environment. The gallbladder is a sac localized under the liver in the human body and is difficult to access for bile and tissue sampling. It concentrates the bile produced in the hepatocytes, which drains into bile canaliculi. Bile promotes fat digestion and is released from the gallbladder into the upper small intestine in response to food. Considered sterile originally, recent data indicate that bile microbiota is associated with the biliary tract’s inflammation and carcinogenesis. The sample size is relevant for omic studies of rare diseases, such as gallbladder carcinoma. Although in its infancy, the study of the biliary microbiota has begun taking advantage of several omics strategies, mainly based on metagenomics, metabolomics, and mouse models. Here, we show that omics analyses from the literature may provide a more comprehensive image of the biliary microbiota. We review studies performed in this environmental niche and focus on network-based approaches for integrative studies.
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Affiliation(s)
- Paola Di Carlo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, Section of Infectious Disease, University of Palermo, Palermo, Italy
| | - Nicola Serra
- Department of Public Health, University “Federico II”, Naples, Italy
| | - Rosa Alduina
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Riccardo Guarino
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Antonio Craxì
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, Section of Gastroenterology, University of Palermo, Palermo, Italy
| | - Anna Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, Section of Microbiology, University of Palermo, Palermo, Italy
| | - Teresa Fasciana
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, Section of Microbiology, University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D’Alessandro, Section of Infectious Disease, University of Palermo, Palermo, Italy
| | - Consolato M. Sergi
- Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Consolato M. Sergi,
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Serra N, Di Carlo P, D'Arpa F, Battaglia E, Fasciana T, Gulotta G, Maida CM, Rodolico V, Giammanco A, Sergi C. Human bile microbiota: A retrospective study focusing on age and gender. J Infect Public Health 2021; 14:206-213. [PMID: 33486377 DOI: 10.1016/j.jiph.2020.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS The emerging biliary colonization of microorganisms in patients with biliary diseases may be devastating. Recent evidence suggests that age and gender may influence changes in the microbial composition of gut microbiota. To study the relationship between these parameters on bile microbiota, we retrospectively reviewed positive bile cultures following an endoscopic retrograde cholangiopancreatography (ERCP) in a QA-certified academic surgical unit of a single institution. METHODS 449 positive bile cultures from 172 Italian patients with diseases of the biliopancreatic system hospitalized from 2006 through 2017 were investigated for aerobic, anaerobic, and fungal organisms. The patients were stratified into four age intervals (22-66, 67-74, 75-81, and 82-93 years) and followed up for five years. RESULTS Gram-positive bacteria (GPB) was negatively associated with age only in multivariate analysis (Rpartial = -0.114, p = 0.017), with younger patients prone to harbor GPB and older patients likely to have Gram-negative bacteria (GNB). There was a definite link with the male gender using both univariate and multivariate analysis (p < 0.001). Enterococcus spp. was the most common strain identified in patients with GPB except for patients aged 67-74 years for male (95.2%) and female (80.9%) patients. Escherichia coli and Klebsiella spp. were most frequent than others in every group analyzed. Analogous results were found for bacteria Non-fermenting Gram-negative bacilli (NFGNB), such as Pseudomonas spp. and Stenotrophomonas spp. apart of the 2nd quartile. CONCLUSIONS Our study strengthens the bond of age and gender with bile microbiota composition and suggests that further investigations may be required in targeting the aging microbiome. Other studies should also focus on Mediterranean epidemiological characteristics and antibiotic resistance surveillance system strategies.
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Affiliation(s)
- Nicola Serra
- Department of Public Health, University "Federico II", Neaples, Italy.
| | - Paola Di Carlo
- Department of Sciences for Health Promotion and Mother & Child Care, Section of Infectious Disease, University of Palermo, Italy.
| | - Francesco D'Arpa
- Department of General Surgery and Emergency, University of Palermo, Italy.
| | - Emanuele Battaglia
- Department of General Surgery and Emergency, University of Palermo, Italy.
| | - Teresa Fasciana
- Department of Sciences for Health Promotion and Mother & Child Care, Section of Microbiology, University of Palermo, Italy.
| | - Gaspare Gulotta
- Department of General Surgery and Emergency, University of Palermo, Italy.
| | - Carmelo M Maida
- Department of Sciences for Health Promotion and Mother & Child Care, Section of Hygiene, University of Palermo, Italy.
| | - Vito Rodolico
- Department of Sciences for Health Promotion and Mother & Child Care, Section of Anatomic Pathology, University of Palermo, Italy.
| | - Anna Giammanco
- Department of Sciences for Health Promotion and Mother & Child Care, Section of Microbiology, University of Palermo, Italy.
| | - Consolato Sergi
- Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
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Serra N, Colomba C, Di Carlo P, Palermo G, Fasciana T, Giammanco A, Novo G, Rea T, Marino MM, Argano V, Sergi C. Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population. Cureus 2020; 12:e8338. [PMID: 32617213 PMCID: PMC7325401 DOI: 10.7759/cureus.8338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Infective endocarditis (IE) is an uncommon disease with an involved interplay of clinical and surgical team management. We aimed to define diagnosis parameters and delineate in-hospital management in patients with IE admitted in a tertiary hospital of Southern Italian. Materials and methods Fifty-six consecutive patients (42 males, 14 females; age range: 34-85 years) admitted for IE in the Infectious Diseases, Cardiac Surgery, and Cardiology units, between January 2011 and August 2017, were enrolled. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, and antimicrobial therapy were collected and analyzed. Any comments at the multidisciplinary team meetings were recorded in minutes of and approved. Results We found 83.9% of patients with positive blood cultures. The four most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA: 21.3%), methicillin-sensitive Staphylococcus aureus (MSSA: 17%), Streptococci (14.9%), and Enterococci (14.9%). Both in the univariate and multivariate analysis, we observed a significant positive correlation between surgery and complications. Particularly in the univariate analysis only, surgery was positively correlated to males and C-reactive protein (CPR) at baseline. Also, considering the most common bacteria, it resulted in a positive correlation between surgery and MRSA and Streptococci spp. and between complications and MSSA. Finally, the male gender was positively correlated to MSSA and heart complications, major arterial embolism, septic pulmonary emboli, splenic infarction, and cerebral embolism. Conclusions A blood culture test remains a critical factor for the diagnosis of IE and the antibiotic treatment of susceptible and emerging resistant bacteria. Male gender and heart complications are red flags for prompt operative management.
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Affiliation(s)
- Nicola Serra
- Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, ITA
| | - Claudia Colomba
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro," Promise, University of Palermo, Palermo, ITA
| | - Paola Di Carlo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro," Promise, University of Palermo, Palermo, ITA.,Department of Infectious Disease, Policlinico Paolo Giaccone University Hospital, Palermo, ITA
| | - Gabriele Palermo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro," Promise, University of Palermo, Palermo, ITA
| | - Teresa Fasciana
- Department of Microbiology, University of Palermo, Palermo, ITA
| | - Anna Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro," Promise, University of Palermo, Palermo, ITA
| | - Giuseppina Novo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro," Promise, University of Palermo, Palermo, ITA
| | - Teresa Rea
- Department of Public Health, University of Naples, Naples, ITA
| | - Maria Michela Marino
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, ITA
| | | | - Consolato Sergi
- Medicine and Pathology: Laboratory, University of Alberta, Edmonton, CAN
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Sergi C, Di Carlo P, Gulotta G, D'Arpa F. Biliary microbiota in pancreatic cancer. HPB (Oxford) 2019; 21:1790. [PMID: 31326266 DOI: 10.1016/j.hpb.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 06/07/2019] [Accepted: 06/16/2019] [Indexed: 02/06/2023]
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Di Carlo P, Serra N, D'Arpa F, Agrusa A, Gulotta G, Fasciana T, Rodolico V, Giammanco A, Sergi C. The microbiota of the bilio-pancreatic system: a cohort, STROBE-compliant study. Infect Drug Resist 2019; 12:1513-1527. [PMID: 31354308 PMCID: PMC6578573 DOI: 10.2147/idr.s200378] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/13/2019] [Indexed: 12/11/2022] Open
Abstract
Background: The gut microbiota play an essential role in protecting the host against pathogenic microorganisms by modulating immunity and regulating metabolic processes. In response to environmental factors, microbes can hugely alter their metabolism. These factors can substantially impact the host and have potential pathologic implications. Particularly pathogenic microorganisms colonizing pancreas and biliary tract tissues may be involved in chronic inflammation and cancer evolution. Purpose: To evaluate the effect of bile microbiota on survival in patients with pancreas and biliary tract disease (PBD). Patients and Methods: We investigated 152 Italian patients with cholelithiasis (CHL), cholangitis (CHA), cholangiocarcinoma (CCA), gallbladder carcinoma (GBC), pancreas head carcinoma (PHC), ampullary carcinoma (ACA), and chronic pancreatitis (CHP). Demographics, bile cultures, therapy, and survival rates were analyzed in cohorts (T1 death <6 months; T2 death <12 months; T3 death <18 months, T3S alive at 18 months). Results: The most common bacteria in T1 were E. coli, K. pneumoniae, and P. aeruginosa. In T2, the most common bacteria were E. coli and P. aeruginosa. In T3, there were no significant bacteria isolated, while in T3S the most common bacteria were like those found in T1. E. coli and K. pneumoniae were positive predictors of survival for PHC and ACA, respectively. E. coli, K. pneumoniae, and P. aeruginosa showed a high percentage of resistant bacteria to 3CGS, aminoglycosides class, and quinolone group especially at T1 and T2 in cancer patients. Conclusions: An unprecedented increase of E. coli in bile leads to a decrease in survival. We suggest that some strains isolated in bile samples may be considered within the group of risk factors in carcinogenesis and/or progression of hepato-biliary malignancy. A better understanding of bile microbiota in patients with PBD should lead to a multifaceted approach to rapidly detect and treat pathogens before patients enter the surgical setting in tandem with the implementation of the infection control policy.
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Affiliation(s)
- Paola Di Carlo
- Department of Sciences for Health Promotion, Mother & Child Care, University of Palermo, Palermo, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Naples 'Federico II', Naples, Italy
| | - Francesco D'Arpa
- Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Antonino Agrusa
- Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Gaspare Gulotta
- Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Teresa Fasciana
- Department of Sciences for Health Promotion, Mother & Child Care, University of Palermo, Palermo, Italy
| | - Vito Rodolico
- Department of Sciences for Health Promotion, Mother & Child Care, University of Palermo, Palermo, Italy
| | - Anna Giammanco
- Department of Sciences for Health Promotion, Mother & Child Care, University of Palermo, Palermo, Italy
| | - Consolato Sergi
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.,Department of Laboratory Medicine and Pathology, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
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