Does Periodontal dysbiosis contribute to vascular graft Infection?
Research type
Research Study
Full title
Does Periodontal microbiome dysbiosis contribute to vascular graft infection?
IRAS ID
329311
Contact name
Steven K Rogers
Contact email
Sponsor organisation
Manchester University
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Vascular endograft infection (VEGI) is a destructive complication of vascular reconstructive surgery. Incidence varies from 0.6%-5% but accounts for up to 40% mortality, and limb amputation of 70%. VEGI’s are categorised into extracavity location, primarily in the groin or lower extremities; intracavity, primarily within the abdomen or thorax; and time elapsed from surgery, denoting early or late onset infection. Management of VEGI’s is dependent on the patient's status and the type of infective organism. Management requires early initiation of broad-spectrum antimicrobial therapy administration & removal of infected graft. Antibiotic treatment, along with polymicrobial biofilm formation around the graft, decreases the sensitivity of routine laboratory culture-based methods to identify the causative organism. Microbiological data on organisms associated with VEGI are rarely published as a result.
As a source of infection, The oral cavity harbours an extensive reservoir of microorganisms. In states of oral dysbiosis and disease these are known to cause cardiovascular disease such as atherosclerosis, infective endocarditis, sepsis, and vegetation at prosthetic graft sites. Periodontal disease, and subsequent bacterial spread, is a recognised risk factor for graft infections in cardiovascular surgery, but less so in vascular surgery and could be a contributing factor to VEGI incidence.
This novel prospective study proposes to analyse the correlation between vascular graft infections and periodontal microbiome dysbiosis using standard laboratory testing along with more sensitive and specific microbiological analysis namely, culture-independent nucleic acid amplification method of sample analysis. Using 16S gene microbiome analysis, it is possible to get an overview of the community composition of a microbiome and identify differences between groups and variation within groups for accurate investigation of microbial communities. This analysis method is not affected by antibiotic therapy. Prolonged empirical antibiotic regimes, and side effects, may well be negated if the specific pathogenic organism can be identified to guide antimicrobial therapy.REC name
North East - York Research Ethics Committee
REC reference
24/NE/0103
Date of REC Opinion
5 Jul 2024
REC opinion
Further Information Favourable Opinion