title: Dynamics of the surgical microbiota along the cardiothoracic surgery pathway.
abstract: Human skin associated microbiota are increasingly described by culture-independent methods that showed an unexpected diversity with variation correlated with several pathologies. A role of microbiota disequilibrium in infection occurrence is hypothesized, particularly in surgical site infections. We study the diversities of operative site microbiota and its dynamics during surgical pathway of patients undergoing coronary-artery by-pass graft (CABG). Pre-, per-, and post-operative samples were collected from 25 patients: skin before the surgery, superficially and deeply during the intervention, and healing tissues. Bacterial diversity was assessed by DNA fingerprint using 16S rRNA gene PCR and Temporal Temperature Gel Electrophoresis (TTGE). The diversity of Operational Taxonomic Units (OTUs) at the surgical site was analyzed according to the stage of surgery. From all patients and samples, we identified 147 different OTUs belonging to the 6 phyla Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes, Cyanobacteria, and Fusobacteria. High variations were observed among patients but common themes can be observed. The Firmicutes dominated quantitatively but were largely encompassed by the Proteobacteria regarding the OTUs diversity. The genera Propionibacterium and Staphylococcus predominated on the preoperative skin, whereas very diverse Proteobacteria appeared selected in peri-operative samples. The resilience in scar skin was partial with depletion in Actinobacteria and Firmicutes and increase of Gram-negative bacteria. Finally, the thoracic operative site presents an unexpected bacterial diversity, which is partially common to skin microbiota but presents particular dynamics. We described a complex bacterial community that gathers pathobionts and bacteria deemed to be environmental, opportunistic pathogens and non-pathogenic bacteria. These data stress to consider surgical microbiota as a "pathobiome" rather than a reservoir of individual potential pathogens.
authors: Equipe Pathogènes et Environnements, UMR 5119 ECOSYM, Université Montpellier 1 Montpellier, France ; Département d'Hygiène Hospitalière, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Sara
authors: S
authors: Romano-Bertrand
authors: Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Jean-Marc
authors: JM
authors: Frapier
authors: Département de Réanimation de Chirurgie Cardiothoracique, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Brigitte
authors: B
authors: Calvet
authors: Département de Réanimation de Chirurgie Cardiothoracique, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Pascal
authors: P
authors: Colson
authors: Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Bernard
authors: B
authors: Albat
authors: Equipe Pathogènes et Environnements, UMR 5119 ECOSYM, Université Montpellier 1 Montpellier, France ; Département d'Hygiène Hospitalière, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Sylvie
authors: S
authors: Parer
authors: Equipe Pathogènes et Environnements, UMR 5119 ECOSYM, Université Montpellier 1 Montpellier, France ; Département d'Hygiène Hospitalière, Centre Hospitalier Régional Universitaire de Montpellier Montpellier, France.
authors: Estelle
authors: E
authors: Jumas-Bilak
keywords: Propionibacterium; Proteobacteria; Staphylococcus; dysbiosis; microbial diversity; pathobiome; surgical wound; temporal temperature gel electrophoresis
references: Eur J Cardiothorac Surg. 2012 Jun;41(6):1304-8
references: 22241000
references: Eur J Cardiothorac Surg. 2002 May;21(5):825-30
references: 12062270
references: J Clin Microbiol. 2002 Aug;40(8):2936-41
references: 12149355
references: Curr Opin Cardiol. 2001 Sep;16(5):306-9
references: 11584170
references: Annu Rev Pathol. 2012;7:99-122
references: 21910623
references: PLoS Comput Biol. 2012;8(12):e1002808
references: 23300406
references: Eur J Clin Microbiol Infect Dis. 2015 Feb;34(2):287-301
references: 25169966
references: Proc Natl Acad Sci U S A. 2007 Feb 20;104(8):2927-32
references: 17293459
references: PLoS One. 2014 Apr 18;9(4):e95476
references: 24748167
references: Eur J Cardiothorac Surg. 2011 Aug;40(2):347-51
references: 21277786
references: J Clin Microbiol. 2014 May;52(5):1317-21
references: 24430456
references: Microbiol Res. 2014 Sep-Oct;169(9-10):686-92
references: 24656938
references: J Cardiothorac Vasc Anesth. 2009 Aug;23(4):488-94
references: 19376733
references: Eur J Clin Microbiol Infect Dis. 2014 Oct;33(10):1763-71
references: 24816901
references: BMC Microbiol. 2007 Nov 30;7:108
references: 18047683
references: Infect Control Hosp Epidemiol. 2008 Oct;29(10):990-2
references: 18808348
references: J Clin Microbiol. 2010 Aug;48(8):3027-9
references: 20534804
references: Ann Thorac Surg. 2010 May;89(5):1502-9
references: 20417768
references: PLoS One. 2014 Apr 14;9(4):e94863
references: 24733310
references: Microbiome. 2013 Dec 23;1(1):31
references: 24451201
references: Nature. 2012 Jun 13;486(7402):207-14
references: 22699609
references: Braz J Microbiol. 2014 May 19;45(1):175-83
references: 24948928
references: Genome Res. 2008 Jul;18(7):1043-50
references: 18502944
references: Nutrition. 2010 Apr;26(4):349-53
references: 20053534
references: J Microbiol Methods. 2009 Nov;79(2):156-65
references: 19686785
references: J Med Microbiol. 2005 Dec;54(Pt 12):1231-8
references: 16278439
references: J Bone Joint Surg Am. 2014 Sep 3;96(17):1447-50
references: 25187583
references: Front Cell Infect Microbiol. 2014 Mar 05;4:29
references: 24634890
references: Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78; quiz 279-80
references: 10219875
references: Appl Environ Microbiol. 2002 Aug;68(8):3691-701
references: 12147461
references: Science. 2009 May 29;324(5931):1190-2
references: 19478181
references: J Bacteriol. 2011 May;193(10):2608-18
references: 21398532
references: J Clin Microbiol. 2008 Jul;46(7):2435-7
references: 18495852
references: Appl Environ Microbiol. 2012 Aug;78(16):5520-8
references: 22660713
references: Transpl Infect Dis. 2011 Apr;13(2):200-3
references: 20854281
references: Appl Environ Microbiol. 2012 Sep;78(18):6438-49
references: 22773636
references: Microb Ecol. 2013 Apr;65(3):781-91
references: 23504024
references: Ann Thorac Surg. 2006 Aug;82(2):715-6
references: 16863793
references: Diagn Microbiol Infect Dis. 2006 Dec;56(4):345-9
references: 16930920
references: APMIS. 2007 Sep;115(9):1001-7
references: 17931237
references: J Clin Microbiol. 2012 Aug;50(8):2561-7
references: 22593594
references: Sci Transl Med. 2009 Nov 11;1(6):6ra14
references: 20368178
references: J Clin Microbiol. 2000 Oct;38(10):3623-30
references: 11015374
references: PLoS One. 2012;7(12):e53048
references: 23300859
references: Anaerobe. 2008 Dec;14(6):310-2
references: 19084607
references: Nucleic Acids Res. 1993 Jul 1;21(13):3025-49
references: 8332525
references: Genome Biol. 2012 Nov 15;13(11):R101
references: 23153041
references: PLoS One. 2013;8(4):e60802
references: 23577162
references: Front Microbiol. 2012 Aug 21;3:290
references: 22934091
references: PLoS One. 2014 Oct 01;9(10):e108924
references: 25271941
references: Nat Rev Microbiol. 2011 Apr;9(4):244-53
references: 21407241
references: J Pediatr. 2011 Mar;158(3):390-6
references: 20961563
references: PLoS One. 2012;7(10):e46231
references: 23056268
references: Nature. 2007 Oct 18;449(7164):811-8
references: 17943117
references: ISME J. 2007 May;1(1):56-66
references: 18043614
references: Nat Rev Genet. 2011 Dec 16;13(1):47-58
references: 22179717
references: Infect Control Hosp Epidemiol. 2013 Jun;34(6):597-604
references: 23651890