IDDF2023-ABS-0139 Enterotype-dependent microbial response to cardiac surgery with cardiopulmonary bypass

BackgroundIntestinal ischemia-reperfusion during cardiac surgery with cardiopulmonary bypass (CPB) may trigger bacterial translocation and contribute to the development of sepsis. In this study, we aimed to investigate the intricate relationship between gut microbial dysbiosis and sepsis after cardiac surgery with CPB.MethodsThis prospective observational case-control study followed 60 patients who underwent cardiac surgery with CPB, with 54 fecal samples collected one day before surgery and 33 samples within 24–72 hours after surgery. Metagenomic sequencing was performed to analyze the gut microbiome. Patients with postoperative sepsis were identified according to the third international consensus (Sepsis-3).ResultsTwo dysbiotic enterotypes were identified in all gut microbial samples (IDDF2023-ABS-0139 Figure 1. Two enterotypes identified in all samples. (A) JSD-based PCoA plot at the genus level. (B) Shannon diversity. (C) The variation of the four enterotype-driven genera). Enterotype I exhibited higher alpha diversity (p=2.7×10–5) and was driven by Citrobacter and Fusicatenibacter, while enterotype II was driven by Cronobacter and Pluralibacter. In addition, an abundance of Citrobacter and Cronobacter were positively correlated (p