Acute Appendicitis in Children Is Associated With a Local Expansion of Fusobacteria

Rogers, Matthew B.; Brower–Sinning, Rachel; Firek, Brian; Zhong, Diana; Morowitz, Michael J.

doi:10.1093/cid/ciw208

Cited by 69 publications

(55 citation statements)

References 37 publications

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“…The LEfSe analysis found that premature infants in BM group and the FM group had only significant differences among the three bacteria. Fusobacterium is an anaerobic Gram-negative pathogen that causes appendicitis in children (Rogers et al, 2016) and is found in murine model to result in premature (Han et al, 2004). Bacteria from the Prevotella family had been found to be higher in formula fed infants than breast fed infants (Holgerson et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Different Effects of Premature Infant Formula and Breast Milk on Intestinal Microecological Development in Premature Infants

Chen

Yin

et al. 2020

Front. Microbiol.

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Intestinal microecology has been shown to participate in the pathogenesis of many diseases through different pathways, and the intestinal microecology of premature infants is significantly different from full-term infants. Intestinal microecology in premature infants is affected by various factors such as gestational age, diet, antibiotic use. However, there are few studies focus on the effects of diet on intestinal microecological development in premature infants. This study explored the different effects of the formula milk (FM) and breast milk (BM) for the development of intestinal microecology in premature infants. The results showed that BM feeding increases the alpha diversity of the intestinal flora, however, FM feeding contributes to the increase in short-chain fatty acids (SCFAs) in the gut of preterm infants. The growth environment has an important influence on the β diversity of intestinal microecology, the genomic function, and the evolution of intestinal microecology in premature infants. The intestinal microecology in premature infants is significantly associated with gestational age and weight gain. This study explored the effects of feeding methods and growth environment on intestinal microecology in premature infants, and provided a basis for promoting the healthy development of premature infants.

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Section: Discussionmentioning

confidence: 99%

Different Effects of Premature Infant Formula and Breast Milk on Intestinal Microecological Development in Premature Infants

Chen

Yin

et al. 2020

Front. Microbiol.

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“…37,40,41,[44][45][46][47] Transmission routes were associated with food borne transmission 35,39 and fomite transmission; 37,47 Measures for control of infectious diseases seem to be effective to prevent appendicitis. 47 Since 2009, new studies have provided compelling evidence of an association between appendicitis and the presence of Fusobacteria in the appendices, [64][65][66][67][68][69] and Fusobacteria were also found in clustering patients we reported in 2012. 38 Study of cluster/outbreak will provide new methods to confirm causal association between microbiota and different entity of appendicitis.…”

Section: Discussionmentioning

confidence: 81%

Demonstration of different entity of appendicitis and related causes of disease through study of cluster/outbreak: Systematic Review and Meta Analysis

Guo

Liu

Sheng

et al. 2019

Preprint

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ObjectiveTo demonstrate different entities of appendicitis and causal association between microbiota and different types of appendicitis through studying cluster/outbreak, and providing guidance to find new cluster/outbreak of appendicitis and the epidemiological evidences of infectious etiology of appendicitis. Data SourcesPubMed, Embase, CNKI, WanFang, VIP, CBM from their establishment to Jan, 2019, and the references lists from retrieved reports. Study EligibilityReports on cluster/outbreak of appendicitis and reports of case series occurring in cluster/outbreak worldwide according to CDC's definition of cluster/outbreak . Data Extraction and SynthesisTwo researchers independently assessed report quality and extracted data according to Moose. We used random effect model for meta-analysis by Meta-Analyst ß3.13 software. Study-level assessment was conducted according to investigation methods introduced byReingold and outcome-level assessment by GRADE system. We selected outcome measures before data collection began. Results 3We included 10 clusters/outbreaks of appendicitis from China and USA with total 626 patients. We demonstrated two entities, type 1 appendicitis (455 patients) and type 2 appendicitis (151patients). 20 patients left were unclassified type. For type 1 appendicitis, Natural history showed progression from a non-perforated appendicitis to perforated appendicitis as described traditionally. More than 88% of patients had elevated body temperature, WBC and neutrophil percentage. For type 2 appendicitis, natural history showed that only a few patients developed into phlegmonous appendicitis (6.9%, ) or acute gangrenous appendicitis (1.4%) and no perforation or periappendicular abscess.More than 78% of patients had normal body temperature, WBC and NP. The patients' time of type 1 appendicitis is shorter than that of type 2 appendicitis. Type 2 appendicitis had different histological features from type 1 appendicitis and was associated with fusobacteria. 9 of 10 cluster/outbreak occurred in group living unity such as school and camps, and many of them showed features of infectious diseases. The bodies of evidence were high quality in Meta analysis. ConclusionCluster/outbreak of appendicitis is more often than expected worldwide and occurred in group living unity. Sporadic perforated appendicitis and non-perforated appendicitis may be not two different entities, but different stages of a same entity, which is inconsistent with modern classification of appendicitis. Type 2 appendicitis is a new entities. Studying cluster/outbreak is a new method in finding of new entity and causal association between microbiota and different types of appendicitis. Epidemiological evidence supported infectious etiology of appendicitis.

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“…Recently, several trials have focused on the non-operative treatment for AA [18,22] . Studies suggested that different treatment strategies should be selected according to the type of AA: simple appendicitis should be the preferred antibiotic conservative treatment, while complicated appendicitis requires appendectomy in most cases [6,15] . Children appendix is not a non-functional organ left in the body.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical presentation, Pediatric Appendicitis Score (PAS), ALVARADO score, Computed tomography, ultrasound and blood tests, may be helpful in diagnose of AA, but it is difficult to confirm the type of appendicitis (simple or complicated appendicitis) [3][4][5] . Been able to diagnose uncomplicated vs. complicated appendicitis allows the surgeon to choose the best surgical approach ranging from antibiotics and delayed appendectomy to laparotomy [6] . Perforated appendicitis after surgery requires antibiotic mono or combination therapy [7] .…”

Section: Introductionmentioning

confidence: 99%

C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

Feng

Yang

Xing

et al. 2020

Preprint

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Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

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Acute Appendicitis in Children Is Associated With a Local Expansion of Fusobacteria

Abstract: These results indicate that the appendiceal niche harbors distinct microbial populations that likely contribute to the pathogenesis of appendicitis, which may one day be leveraged to improve the diagnosis and/or treatment of patients with AA.

Cited by 69 publications

References 37 publications

Different Effects of Premature Infant Formula and Breast Milk on Intestinal Microecological Development in Premature Infants

Different Effects of Premature Infant Formula and Breast Milk on Intestinal Microecological Development in Premature Infants

Demonstration of different entity of appendicitis and related causes of disease through study of cluster/outbreak: Systematic Review and Meta Analysis

C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

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