Antibiotic-associated Enterococcus expansion in the gastrointestinal tract precedes infected necrosis in acute necrotizing pancreatitis

Fons F. van den Berg; Hannah S. Pauw; Hester C. Timmerhuis; M G Besselink; Yama Issa; Marco J. Bruno; Pieter Jan de Jonge; Harry van Goor; Erwin J. M. van Geenen; R Quispel; Wim van de Vrie; Adriaan Tan; Muhammed Hadithi; Niels G. Venneman; Rogier P. Voermans; Jeroen M. Jansen; Ben J. Witteman; Matthijs P. Schwartz; Roy L. J. van Wanrooij; AC Poen; Peter van Duijvendijk; Marie- Paule Anten; Tessa E H Römkens; Elske Sieswerda; Merel M. Tielemans; Jeanin E. van Hooft; Marja A. Boermeester; Robert C. Verdonk; Hjalmar C. van Santvoort

doi:10.1080/19490976.2026.2670039

Key Points

The aim is to investigate the relationship between antibiotic-associated Enterococcus expansion and infected necrosis in acute pancreatitis.
Analyzed gastrointestinal microbiome changes in patients with acute necrotizing pancreatitis.
Measured abundance of butyrate producers and Enterococcus species.
Assessed the relationship between microbiome alterations and clinical outcomes.
Colonization of Enterococcus significantly associated with infected necrosis (HR 3.56, 95% CI 1.23-10.28).
Lower abundance of butyrate producers linked to infected necrosis (HR 4.99, 95% CI 1.57-15.80).
Findings suggest need for more restrictive antibiotic policies in early acute pancreatitis.

Implication

Examines enterococcus expansion and infected necrosis in acute pancreatitis, suggesting need for cautious antibiotic use.

Abstract

colonisation (HR 4.99, 95% CI 1.57-15.80), reduced butyrate-producer abundance, and infected necrosis (HR 3.56, 95% CI 1.23-10.28). Whether this relationship is causal warrants further investigation, but if confirmed, it would warrant a more restrictive antibiotic policy in early acute pancreatitis.

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Cite This Study

Berg et al. (2026) studied this question.

synapsesocial.com/papers/6a0aad145ba8ef6d83b7095f https://doi.org/10.1080/19490976.2026.2670039

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Antibiotic-associated Enterococcus expansion in the gastrointestinal tract precedes infected necrosis in acute necrotizing pancreatitis

Key Points

Implication

Abstract

Discussion

Cite This Study

Antibiotic-associated Enterococcus expansion in the gastrointestinal tract precedes infected necrosis in acute necrotizing pancreatitis

Key Points

Implication

Abstract

Discussion

Cite This Study

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