Changes in the bacterial flora of the neoterminal ileum after ileocolonic resection for Crohn's disease.
OBJECTIVE
Bacterial agents have been implicated in the early recurrence of Crohn's disease after ileocolectomy. The aim of our study was to identify and quantify bacteria associated with the ileal mucosa in patients and controls and to correlate specific bacteria with recurrence.


METHODS
The predominant bacterial microflora of the ileum were enumerated and identified, aerobically and anaerobically, in biopsies obtained at the time of surgery or by endoscopy from 61 patients with Crohn's disease and 10 ileocolectomy controls. The 61 specimens were comprised of 13 ileal biopsies taken from resection specimens, seven taken after ileostomy, and 41 taken after ileocolectomy.


RESULTS
Ileocolectomy induced a significant increase in bacterial counts and variety in the neoterminal ileum in both patients and controls that was not observed in ileostomy biopsies. Comparison between patients and controls revealed greater numbers of Escherichia coli and enterococci in Crohn's disease and of bifidobacteria and ruminococci in controls. Early recurrence was associated with high counts of E. coli and bacteroides and the frequent isolation of fusobacteria.


CONCLUSIONS
After ileocolectomy, colonization of the neoterminal ileum is increased. Our data suggest that increases in the populations of specific bacteria such as E. coli, enterococci, bacteroides, and fusobacteria may be important in postoperative recurrence of Crohn's disease.
Neut
Christel
C
Laboratoire de Bactériologie, Faculté de Pharmacie, Lille, France.
Bulois
Philippe
P
Desreumaux
Pierre
P
Membré
Jeanne-Marie
JM
Lederman
Emmanuel
E
Gambiez
Luc
L
Cortot
Antoine
A
Quandalle
Pierre
P
van Kruiningen
Herbert
H
Colombel
Jean-Fredéric
JF
D000328:Adult; D001420:Bacteria, Aerobic / Q000302:isolation & purification*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D003082:Colectomy; D015169:Colony Count, Microbial; D003424:Crohn Disease / Q000382:microbiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000382:microbiology*; D007413:Intestinal Mucosa / Q000382:microbiology*; D008297:Male; D012008:Recurrence; D013997:Time Factors