Alterations of gut microbiota in cirrhotic patients with spontaneous bacterial peritonitis: A distinctive diagnostic feature

Abstract

BackgroundSpontaneous bacterial peritonitis (SBP) is a severe infection in cirrhotic patients that requires early diagnosis to improve the long-term outcome. Alterations in the gut microbiota have been shown to correlate with the development and progression of liver cirrhosis. However, the relationship between SBP and gut microbiota remains unknown.MethodsIn this study, we applied 16S rRNA pyrosequencing of feces to ascertain possible links between the gut microbiota and SBP. We recruited 30 SBP patients, 30 decompensated cirrhotic patients without SBP (NSBP) and 30 healthy controls. Metagenomic functional prediction of bacterial taxa was achieved using PICRUSt. ResultsThe composition of the gut microbiota in the SBP patients differed remarkably from that in the NSBP patients and healthy individuals. The microbial richness was significantly decreased, while the diversity was increased in the SBP patients. Thirty-four bacterial taxa containing 15 species, mainly pathogens such as Klebsiella pneumoniae, Serratia marcescens and Prevotella oris, were dominant in the SBP group, while 42 bacterial taxa containing 16 species, especially beneficial species such as Faecalibacterium prausnitzii, Methanobrevibacter smithii and Lactobacillus reuteri, were enriched in the NSBP group. Notably, we found that 18 gene functions of gut microbiota were different between SBP patients and NSBP patients, which were associated with energy metabolism and functional substance metabolism. Five optimal microbial markers were determined using a random forest model, and the combination of Lactobacillus reuteri, Rothia mucilaginosa, Serratia marcescens, Ruminococcus callidus and Neisseria mucosa achieved an area under the curve (AUC) value of 0.8383 to distinguish SBP from decompensated cirrhosis.ConclusionsWe described the obvious dysbiosis of gut microbiota in SBP patients and demonstrated the potential of microbial markers as noninvasive diagnostic tools for SBP at an early stage.

Lacticaseibacillus rhamnosus dfa1 Attenuate Cecal Ligation-Induced Systemic Inflammation through the Interference in Gut Dysbiosis, Leaky Gut, and Enterocytic Cell Energy

“…With a presence of intra-abdominal necrotic tissue in this model, the inflammation in the peritoneal cavity affects the balance of gut microbiota, despite the inflammatory lesions being walled off. Although these data are similar to the dysbiosis in several peritonitis models, such as spontaneous bacterial peritonitis, fecal peritonitis, and peritonitis in peritoneal dialysis [ 62 , 63 , 64 ], the dysbiosis in these situations might not be only from peritonitis alone but also from the underlying overt systemic responses, including cirrhosis, sepsis, and uremia, in these situations that might affect the gut dysbiosis. Here, despite the subtle systemic responses in the cecal ligation model, the alteration in fecal dysbiosis was prominent, supporting a vulnerability of the balance in microbiota in the gut to the microenvironment [ 65 ].…”

Identifying microbe-disease association based on graph convolutional attention network: Case study of liver cirrhosis and epilepsy

“…Our analysis results display that there are four common microbes in the top 20 ranking score lists from liver cirrhosis and epilepsy, i.e., Actinobacteria, Clostridia, Clostridiales and Klebsiella. It is reported that the relative abundances of Actinobacteria and Klebsiella both increase in patients with liver cirrhosis and epilepsy compared with healthy controls ( Chen et al, 2020 ; Lin et al, 2021 ; Dong et al, 2022 ; Zhou et al, 2022 ). Clostridiales with decreased abundance is strongly associated with the severity of liver cirrhosis and the seizure of epilepsy ( Zhang et al, 2018 ; Fukui, 2019 ).…”

Gut Microbiota and Antibiotic Treatments for the Main Non-Oncologic Hepato-Biliary-Pancreatic Disorders

“…A recent study by Zhou et al demonstrated that patients with decompensated cirrhosis and SBP had a decreased microbial richness and increased microbial diversity [ 86 ]. Moreover, they found a different microbiota profile in patients with SBP compared with those without SBP, defined by an increase of 15 species including pathogens such as Klebsiella pneumoniae , Serratia marcescens and Prevotella oris and a decrease of some beneficial bacterial taxa, such as Faecalibacterium prausnitzii , Methanobrevibacter smithii and Lactobacillus reuteri [ 86 ]. Other studies revealed that Enterobacteriaceae are the most commonly translocated microbes identified in ascitic fluid of cirrhotic patients, and a higher proportion of Gram-negative bacteria in their gut microbiome was pointed out as the cause of SBP [ 8 ].…”

“…Therefore, these findings suggest that K. pneumoniae may translocate from the intestine to cause SBP. In cirrhotic patients with SBP, the abundance of the beneficial bacteria Faecalibacterium prausnitzii is negatively correlated with white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT) and Child–Turcotte–Pugh (CTP) score, while the abundance of E. coli was positively correlated with WBC, CTP score and Mayo End stage Liver Disease (MELD) score [ 86 ].…”

“…The profound dysbiosis which characterizes liver cirrhosis is strictly linked to SBP. A recent study by Zhou et al demonstrated that patients with decompensated cirrhosis and SBP had a decreased microbial richness and increased microbial diversity [86]. Moreover, they found a different microbiota profile in patients with SBP compared with those without SBP, defined by an increase of 15 species including pathogens such as Klebsiella pneumoniae, Serratia marcescens and Prevotella oris and a decrease of some beneficial bacterial taxa, such as Faecalibacterium prausnitzii, Methanobrevibacter smithii and Lactobacillus reuteri [86].…”