Abstract
Anal abscesses and fistulas are potential complications of Crohn’s disease (CD). Chronic immunosuppression, loose stools, and poor wound healing in this population present challenges to the management of perianal diseases. The purpose of the study was to determine the predominant bacterial species found in specimens from perianal lesions causing anal abscess and/or fistula drainage in hospitalized patients, and to compare the number and type of microorganisms isolated from samples taken from patients undergoing biological therapy or traditionally treated. The outcomes of studies of patients treated for anal abscesses or fistulas from 2017 to 2019 were evaluated. Data obtained from medical records included culture and antibiotic sensitivity results of swabs from perianal lesions of isolated microorganisms. A total of 373 swabs were collected from perianal lesions during the analysis period, including 51 (49 positive samples) from patients with CD. The predominant pathogen was Escherichia coli (55%, p < 0.001), the second most common microorganism was Staphylococcus aureus (14.3%, p < 0.001). In vitro susceptibility testing showed E. coli, ESBL (strain with Extended Spectrum Beta-Lactamase) in five cases, S. aureus, MRSA (methicillin-resistant S. aureus -resistant to all beta-lactam antibiotics: penicillins with inhibitors, cephalosporins, monobactams, carbapenems, except for ceftaroline) in one sample. Biologic therapy does not affect the type of microorganisms isolated from perianal abscesses in patients with CD.
Highlights
Both anal abscesses and fistulas are potential complications in the course of Crohn’sDisease (CD)
Biologic therapy does not affect the type of microorganisms isolated from perianal abscesses in patients with Crohn’s disease (CD)
Since knowledge about resistance patterns is advantageous, in our study, we aimed to evaluate the microbial profile in a number of bacterial cultures obtained from perianal abscesses and fistula discharge
Summary
Both anal abscesses and fistulas are potential complications in the course of Crohn’sDisease (CD). Both anal abscesses and fistulas are potential complications in the course of Crohn’s. Loose stools and poor wound healing in this population pose a challenge when treating the perianal disease [1,2]. It is commonly believed that the intestinal microbiome plays an essential role in the pathogenesis of Crohn’s disease, the microorganism or group of microorganisms involved remains elusive, despite technological advances in molecular biology that facilitate their detection. It is important that the fistula tracts themselves lack mucosa-associated microbiota which may have relevance for the presumed microbial-immune interaction believed to drive inflammation [6]. The role of bacterial colonization in both pathogenesis of perianal abscesses and fistulas remains unclear at present; still, empirical antibiotic treatment, mostly comprising ciprofloxacin alone or in combination with metronidazole, is used on a regular basis [7,8]
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