Oesophageal Microbial Flora in Carcinoma of the Oesophagus

Abstract

In 79 patients, with carcinoma of the oesophagus, oesophageal aspirates obtained at oesophagoscopy were cultured for aerobic and anaerobic organisms in an attempt to identify the microbial flora. The aspirate culture was correlated with the pathogens isolated when infective complications developed after operation. Bacteroides was isolated from the oesophagus in 39.2% of patients, streptococcus in 10.1% and coliform oganisms in 7.6%. No growth was obtained in 35.4% patients. Forty-one patients underwent oesophageal resection. Six of these had the complication of empyema thoracis in the postoperative period. Two patients had identical organisms isolated from the oesophagus and the empyema. B. melaninogenicus was cultured from the pleural fluid in two patients whose oesophageal aspirate culture yielded no growth. Six patients developed wound infection, all with anastomotic cutaneous fistula. There was no demonstrable relationship between the organisms isolated from the two sources. Prophylactic antibiotic administration should be directed against the bacteroides. since it is the most common organism isolated from within the oesophagus.

Digestive Tract Microbiota in Healthy Volunteers

“…However, when alimentary stasis occurs, as in neoplasia or achalasia, 40,41 there is an excessive increase in bacterial growth, with the risk of serious infections after surgery or endoscopy. 42,43 Sample collection for studying the microbiota of the esophagus cannot be performed with catheters that pass through the mouth because of the risk of contamination during their insertion. The use of sterile catheters that pass through the working channel of an endoscope is expensive and does not permit aspiration of sufficient thick material from an esophagus with stasis.…”

Microbiome in Reflux Disorders and Esophageal Adenocarcinoma

“…19,20,21 This work was burdened by the contemporary belief that no indigenous bacteria populated the esophagus. Cultivation of luminal washes was unable to consistently show the presence of bacteria (Table 1).…”

“…17,19,20,21 Because these two cancers have marked differences in epidemiology and etiology, these studies cannot be assumed to be applicable to EA and thus will not be discussed here. To date, there has been only one published study to address the link between the microbiome and EA, in which Blackett and colleagues compared 30 cases of EA with 39 cases of controls using culture analysis.…”

Potential Role of the Microbiome in Barrett’s Esophagus and Esophageal Adenocarcinoma

“…Like the stomach, the esophagus was long thought to be a relatively sterile environment. Early studies using cultivation of esophageal washes isolated few organisms, which were typically attributed to transient passage of oropharyngeal contents (39-41). However, Pei et al, using culture-independent techniques, characterized a diverse esophageal microbiome using mucosal biopsies of four patients undergoing upper endoscopy and without esophageal disease (42).…”

“…Several early culture-based studies of esophagectomy specimens from both EAC and squamous cell cancer carried out in the 1980s did not note any difference in organisms isolated in benign versus malignant tissue, however these studies were more concerned with identifying pathogens associated with post-surgical infections than characterizing differences in non-pathogenic bacteria between patients with EAC and control patients (39-41). A more recent study using 16S sequencing of normal versus tumor tissue in esophageal cancer patients found increased Treponema denticola in tumor tissue, but the histologic subtypes of the tumors analyzed was not specified (49).…”