LB053 - STOMA STATUS IS ASSOCIATED WITH DISTINCT INTESTINAL MICROBIOME PROFILES IN CHRONIC INTESTINAL FAILURE

LB053

STOMA STATUS IS ASSOCIATED WITH DISTINCT INTESTINAL MICROBIOME PROFILES IN CHRONIC INTESTINAL FAILURE

E. M. Friederici¹, L. Buchholz^1,*, S. K. Klug¹, F. Seltsam¹, N. Sadowski¹, S. Arndt¹, K. Bohlen¹, I. Kraiselburd², B. Hild¹

¹Gastroenterology, Hepatology and Transplantation Medicine, ²IKIM, University Hospital Essen, Essen, Germany

 

Rationale: Chronic intestinal failure (CIF), most commonly caused by short bowel syndrome, requires long-term intravenous or parenteral supplementation [1,2]. Despite its morbidity, the adult CIF microbiome remains poorly characterized, while emerging data suggest dysbiosis shaped by surgical anatomy, parenteral nutrition dependence, and bowel continuity [3–5]. This study investigated microbiome composition and clinical and metabolic associations in CIF.

Methods: In this prospective study, adults with CIF due to short bowel syndrome were recruited at University Hospital Essen. Blood and mucosal samples were collected longitudinally. Microbiome composition was analyzed by 16S rRNA sequencing, complemented by serum metabolomics and clinical assessment. Diversity, group comparisons, and correlations were performed.

Results: Forty-seven patients were included (median age 53.7 years, IQR 37.2–60.3); 31 were female. Short bowel types 1, 2, and 3 were present in 13, 21, and 9 patients; in 4, type was absent or unknown. Fifteen patients had a stoma. Thirty-one patients provided microbiome samples: 15 with and 16 without stoma. Alpha diversity did not differ by stoma status (Shannon index, p=0.416). Beta diversity showed significant separation by stoma status (PERMANOVA R²=0.133, p=0.001). Both groups were dominated by Firmicutes, but stoma patients showed lower Firmicutes (61.6% vs. 78.9%) and higher Proteobacteria (23.6% vs. 2.7%). At genus level, Escherichia/Shigella, Klebsiella and Streptococcus were enriched in stoma patients.

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Conclusion: Stoma status is associated with significant differences in CIF microbiome composition, characterized by reduced Firmicutes, increased Proteobacteria, and enrichment of potentially pathogenic genera. These findings support surgical anatomy as an important determinant of CIF microbiome composition.

References: 1) PMID:25311444.

2) PMID:37639741.

3) PMID:38677044.

4) PMID:34816756.

5) PMID:31032975.

Disclosure of Interest: None declared