Differences in microbiota profiles of simple and complicated pediatric appendicitis cases

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Öksüz L., Özdemir E., Tunçer İ., Yüksel S., Karaman T., Erginel B.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY, cilt.16, ss.1-13, 2026 (Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 16
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3389/fcimb.2026.1966569
  • Dergi Adı: FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
  • Derginin Tarandığı İndeksler: Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest), Scopus, BIOSIS, EMBASE, MEDLINE, Directory of Open Access Journals, Zoological Record
  • Sayfa Sayıları: ss.1-13
  • İstanbul Üniversitesi Adresli: Evet

Özet

This study aimed to identify the differences in microbial composition between

simple appendicitis (SA) and complicated appendicitis (CA) in a limited sample size

using culture and microbiota analysis. Appendix tissues and rectal swabs for

microbiota analysis and conventional cultures were collected from patients. 16S

rRNA regions were amplified using a DNA preparation kit with primers designed to

target the V3-V4 region. Sixteen (41%) of the patients were classified as CA based on

the histopathological analysis, and the rest as SA. The effect size was slightly greater

in rectal swab samples than in appendiceal tissue samples. Based on the conventional

culture, themost common aerobic bacteria were Escherichia, Klebsiella spp.,

and Enterococcus spp. A decrease in both Pseudomonadota and Bacteriodota

phyla was observed in tissue samples, while a decrease in Bacteriodota and an

increase in Pseudomonadota were observed in rectal samples. Differences in the

relative abundance of Coprobacter and Hungatella were observed between CAT

and SAT samples; however, no genus-level difference remained significant after

ANCOM-BC2 multiple-testing correction. The most notable feature of the CAT

group was the relatively higher presence of potential pathobionts. Bacteriodes and

Roseburia showed higher relative abundance in the SA rectal (SAR) group. The

genera Eubacterium and Clostridioides showed a significant increase in both the

SAR and CA rectal (CAR) groups. Lower relative abundances of Parvimonas,

Prevotella, and Dialister and a higher relative abundance of Tyzzerella were

observed in CAR compared with controls, although these differences did not

remain significant after multiple-testing correction. In the ANCOM-BC2 pairwise

analysis, an unclassified genus within Enterobacteriaceae was significantly enriched

in CAR compared with healthy controls (LFC = 3.56, q = 0.003). No statistically

significant distinction was shown at the alpha and beta diversity levels between SA

and CA cases. Our findings support previous studies on increased density and

diversity at the phylum level in the CA group. The main limitations were the limited

sample size and the use of pre-operative antibiotics. Microbiota profiling of

appendiceal tissue and rectal swab samples may provide complementary information for understanding microbiota-associated patterns in appendicitis;

however, the diagnostic or predictive utility of these microbial profiles requires

validation in larger, independent cohorts using dedicated predictive modeling and

diagnostic performance analyses