Association Between Bacteremia from Specific Microbes and Subsequent Diagnosis of Colorectal Cancer
Publication in refereed journal

替代計量分析
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其它資訊
摘要BACKGROUND & AIMS:
Colorectal cancer (CRC) development has been associated with increased proportions of Bacteroides fragilis and certain Streptococcus, Fusobacterium, and Peptostreptococcus species in the intestinal microbiota. We investigated
associations between bacteremia from specific intestinal microbes and occurrence of CRC.

METHODS: We performed a retrospective study after collecting data on 13,096 adult patients (exposed group) in Hong Kong hospitalized with bacteremia (identified by blood culture test) without a previous diagnosis of cancer from January 1, 2006 through December 31, 2015. We collected data on intestinal microbes previously associated with CRC (genera Bacteroides, Clostridium, Filifactor, Fusobacterium, Gemella, Granulicatella, Parvimonas, Peptostreptococcus, Prevotella, Solobacterium, and Streptococcus). Clinical information, including patient demographics, comorbid medical conditions, date of bacteremia, and bacterial species identified, were collected. The incidence of biopsy-proved CRC was compared between the exposed and unexposed (patients without bacteremia matched for age, sex, and comorbidities) groups.

RESULTS:
The risk of CRC was increased in patients with bacteremia from B fragilis (hazard ratio [HR] ¼ 3.85, 95% CI ¼ 2.62–5.64, P ¼ 5.5 1012) or Streptococcus gallolyticus (HR ¼ 5.73, 95% CI ¼ 2.18–15.1, P ¼ 4.1 104) compared with the unexposed group. In addition, the risk of CRC was increased in patients with bacteremia from Fusobacterium
nucleatum (HR ¼ 6.89, 95% CI ¼ 1.70–27.9, P ¼ .007), Peptostreptococcus species (HR ¼ 3.06, 95% CI ¼ 1.47–6.35, P ¼ .003), Clostridium septicum (HR ¼ 17.1, 95% CI ¼ 1.82–160, P ¼ .013), Clostridium perfringens (HR ¼ 2.29, 95% CI ¼ 1.16–4.52, P ¼ .017), or Gemella morbillorum (HR ¼ 15.2, 95% CI ¼ 1.54–150, P ¼ .020). We observed no increased risk in patients with bacteremia caused by microbes not previously associated with colorectal neoplasms.

CONCLUSIONS:
In a retrospective analysis of patients hospitalized for bacteremia, we associated later diagnosis of CRC with B fragilis and S gallolyticus and other intestinal microbes. These bacteria might have entered the bloodstream from intestinal dysbiosis and perturbed barrier function. These findings support a model in which specific
members of the intestinal microbiota promote colorectal carcinogenesis. Clinicians should evaluate patients with bacteremia from these species for neoplastic lesions in the colorectum.
出版社接受日期24.04.2018
著者Kwong TNY, Wang XS, Nakatsu G, Chow TC, Tipoe T, Dai RZW, Tsoi KKF, Wong MCS, Tse G, Chan MTV, Chan FKL, Ng SC, Wu JCY, Wu WKK, Yu J, Sung JJY, Wong SH
期刊名稱Gastroenterology
出版年份2018
月份8
卷號155
期次2
頁次383 - 390.e8
國際標準期刊號0016-5085
電子國際標準期刊號1528-0012
語言英式英語
關鍵詞colon cancer, marker, microbiome, pathogen

上次更新時間 2020-16-09 於 00:40