title: The impact of bacterial DNA translocation on early postoperative outcomes in Crohn's patients undergoing abdominal surgery.
abstract: OBJECTIVE
  Bacterial DNA (bactDNA) translocation occurs frequently in patients with Crohn's disease and can be present in patients with a negative blood microbiological culture. We aimed to determine the effects of bactDNA translocation on postoperative outcomes in Crohn's disease patients undergoing abdominal surgery.
  
  
  METHODS
  Patients with Crohn's disease who underwent abdominal surgery between January 2012 and March 2014 were identified. General and postoperative outcome-related information was retrieved from a database, and the data were compared between patients with and without bactDNA translocation. Multivariate analysis was used to determine the independent effect of bactDNA translocation on postoperative morbidity.
  
  
  RESULTS
  One hundred and seven patients who underwent abdominal surgery were included in our study. The presence of bactDNA in blood samples was identified in 29 patients (27.1%). There was a total of 55 complications in 28 patients (26.2%). Patients with bactDNA in their blood had a mean postoperative hospital stay of 12.7±4.2 days and patients without DNA translocation had a mean postoperative hospital stay of 10.1±4.8 days (p = 0.009). The readmission rate was increased in patients with bactDNA translocation (p = 0.032). A low preoperative level of serum albumin (p = 0.024), preoperative immunosuppressive agent use (p = 0.046), and the presence of bactDNA in blood (p = 0.005) were independently associated with increased postoperative adverse outcomes.
  
  
  CONCLUSIONS
  Preoperative bactDNA translocation into the blood increases the incidence of postoperative adverse outcomes in patients with Crohn's disease who undergo abdominal surgery.
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Lugen
authors.initials: L
authors.lastname: Zuo
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China zhuwmjlh@163.com.
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, PR China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood; D003424:Crohn Disease / Q000097:blood / Q000382:microbiology / Q000601:surgery*; D004269:DNA, Bacterial / Q000097:blood*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000382:microbiology*; D057234:Preoperative Period; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial
keywords: Crohn’s disease; abdominal surgery; bacterial DNA; postoperative complication