Project Summary
Using metagenomic shotgun sequencing and metatranscriptomics to deeply phenotype the mucosal microbiota of patients undergoing colorectal resection with the aim to identify microbial factors which affect surgical outcomes, such as healing and anastomotic leaks.
What is the issue for NSW?
Colorectal resection is the main treatment for many diseases that require surgery, including colorectal cancer, diverticular disease, and inflammatory bowel disease. Resection of a segment of the bowel requires reconstruction by re-joining the remaining bowel, or formation of a permanent end stoma. Anastomotic leak occurs when this anastomosis fails in the early post-operative period. This has devastating consequences for the patient (most have salvage surgery at which a stoma is formed) and some do not survive the infective insult (16.4% mortality rate). Despite progress in many aspects of surgical care, leak rates remain high (between 10-15% in large series and cohort studies) with the rate varying between different anastomotic sites. There is indisputable evidence of the gastrointestinal microbiota’s role in the hosts homeostatic function, gastrointestinal disease, and wound healing.
What does the research aim to do and how?
We aim to identify biomarkers from the mucosal microbiota associated with anastomotic leaks and design an appropriate intervention to target this biomarker and improve colorectal surgical outcomes (anastomotic leaks). This will be achieved using metagenomic shotgun sequencing and metatranscriptomics to inform us of the microbiota community composition, functional capability, and specific microbial gene expression.