{
  "abstract": "Objective Patients with acute pancreatitis show reduced gut microbiome diversity and high abundance of pathogenic bacteria compared with healthy subjects. Admission microbiome profiles are increasingly linked to severity, but methodology and study quality hamper interpretation. Our aim was to investigate whether admission microbiome analysis provides robust and reproducible associations with severity and complications of acute pancreatitis.Methods Patients with acute pancreatitis were prospectively enrolled from 20 Dutch hospitals (2019–2022). Admission saliva and rectal samples from 276 patients underwent 16S rDNA sequencing for microbiome profiling. Subgroups were defined based on a literature search. The microbiota endpoints (alpha- and beta-diversity, and genus abundance) were compared across subgroups and with previous studies. Robustness of the significant associations was classified as ‘moderate’ or ‘high’ in case of statistical significance in, respectively, 2 or ≥3 differential abundance models.Results Rectal alpha diversity (Shannon Index 3.55 vs 3.63, p=0.026) was decreased in necrotising (n=49) versus oedematous pancreatitis (n=218). Microbiota communities of either saliva or rectal samples differed in all the subgroups. In total, 270 (rectal) and 138 (saliva) genera were associated with severity or complications, of which 35 and 3 ( Anaeroglobus and Finegoldia in saliva; Lachnospiraceae_FE2018_group in rectal) were classified as, respectively, moderately and highly robust. Fourteen associations were previously reported, of which 10 were in the opposite direction compared with this study.Conclusion Three admission microbiome taxa associated with severity and complications were highly robust, although their biological relevance remains unclear. This study also shows the lack of replicable findings of admission microbiome associations, highlighting the need for longitudinal studies to establish temporal relationships between microbiome changes and disease progression.",
  "authors": [
    {
      "affiliations": [
        "Surgery, St Antonius Hospital, Nieuwegein, Utrecht, The Netherlands",
        "Research & Development, St Antonius Hospital, Nieuwegein, The Netherlands"
      ],
      "name": "Hannah S Pauw"
    },
    {
      "affiliations": [
        "Research & Development, St Antonius Hospital, Nieuwegein, The Netherlands",
        "Surgery, St Antonius Hospital, Nieuwegein, The Netherlands"
      ],
      "name": "Hester C Timmerhuis"
    },
    {
      "affiliations": [
        "Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Noord Holland, The Netherlands",
        "Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Noord-Holland, The Netherlands"
      ],
      "name": "Marc G Besselink"
    },
    {
      "affiliations": [
        "Surgery, Amsterdam UMC Location AMC, Amsterdam, The Netherlands"
      ],
      "name": "Yama Issa"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, The Netherlands"
      ],
      "name": "Marco Bruno"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Pieter Jan Floris de Jonge"
    },
    {
      "affiliations": [
        "Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands"
      ],
      "name": "Harry van Goor"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands"
      ],
      "name": "Erwin-Jan M van Geenen"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, DELFT, Zuid-Holland, The Netherlands"
      ],
      "name": "Rutger Quispel"
    },
    {
      "affiliations": [
        "Gastroenterology, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands"
      ],
      "name": "Wim van de Vrie"
    },
    {
      "affiliations": [
        "Gastroenterology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands"
      ],
      "name": "Adriaan Tan"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, Zuid-Holland, The Netherlands"
      ],
      "name": "Muhammed Hadithi"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Medical Spectrum Twente, Enschede, The Netherlands"
      ],
      "name": "Niels G Venneman"
    },
    {
      "affiliations": [
        "Gastroenterology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands"
      ],
      "name": "J M Jansen"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Hospital Gelderse Vallei, Ede, The Netherlands"
      ],
      "name": "Ben J Witteman"
    },
    {
      "affiliations": [
        "Internal Medicine and Gastroenterology, Meander Medical Center, Amersfoort, The Netherlands"
      ],
      "name": "Matthijs P Schwartz"
    },
    {
      "affiliations": [
        "Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Noord-Holland, The Netherlands",
        "Gastroenterology and Hepatology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, The Netherlands"
      ],
      "name": "Roy L J van Wanrooij"
    },
    {
      "affiliations": [
        "Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Noord-Holland, The Netherlands",
        "Gastroenterology and Hepatology, Gastroenterology and Metabolism institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands"
      ],
      "name": "Rogier P Voermans"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands"
      ],
      "name": "Alexander C Poen"
    },
    {
      "affiliations": [
        "Surgery, Gelre Hospitals, Apeldoorn, The Netherlands",
        "Surgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands"
      ],
      "name": "Peter van Duijvendijk"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Franciscus Gasthuis, Rotterdam, ZH, The Netherlands"
      ],
      "name": "Marie Paule G F Anten"
    },
    {
      "affiliations": [
        "Gastroenterology and hepatology, Jeroen Bosch Ziekenhuis, Den Bosch, Noord-Brabant, The Netherlands"
      ],
      "name": "Tessa Römkens"
    },
    {
      "affiliations": [
        "Medical Microbiology, Utrecht University, Utrecht, The Netherlands",
        "Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands"
      ],
      "name": "Elske Sieswerda"
    },
    {
      "affiliations": [
        "Gastroenterology and Hepatology, Bravis Hospital, Bergen op Zoom, The Netherlands",
        "Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands"
      ],
      "name": "Merel M Tielemans"
    },
    {
      "affiliations": [
        "Gastroenterology & Hepatology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Jeanin E van Hooft"
    },
    {
      "affiliations": [
        "Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Noord-Holland, The Netherlands",
        "Surgery, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"
      ],
      "name": "Marja A Boermeester"
    },
    {
      "affiliations": [
        "Gastroenterology & Hepatology, Sint Antonius Hospital, Nieuwegein, The Netherlands"
      ],
      "name": "Robert C Verdonk"
    },
    {
      "affiliations": [
        "Surgery, St Antonius Hospital, Nieuwegein, Utrecht, The Netherlands",
        "Surgery, University Medical Center Utrecht, Utrecht, The Netherlands"
      ],
      "name": "Hjalmar C van Santvoort"
    },
    {
      "affiliations": [
        "Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Noord-Holland, The Netherlands",
        "Medical Microbiology and Infection Prevention, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands",
        "Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam, The Netherlands"
      ],
      "name": "Fons F van den Berg"
    }
  ],
  "title": "Identification of robust associations between admission microbiome profiles and complications of acute pancreatitis",
  "uid": "2b0e73dd-5194-5532-9ca7-32a358089da3"
}