Gut microbes of the cecum versus the colon drive more severe lethality and multi-organ damage

An intestinal perforation or puncture leads to a high risk of sepsis-associated morbidity. A perforation initiates the transfer of the intestinal contents (ICs) to the peritoneal cavity, leading to abdominal infections and varying with different prognoses. However, the mechanisms associated with different perforations in the cecum and colon remain unknown. We sought to examine how different gut flora contribute to prognoses in different intestinal perforation sites. We compared the microbiome of the ICs in the cecum and colon in a fecal-induced peritonitis mouse model. The results showed that cecum ICs developed more severe sepsis than colon ICs, including a shorter median survival time, increased biochemical indicators, more pathological changes in multiple organs and overwhelmed systematic inflammation. Moreover, our results demonstrated that cecum ICs hold more bacterial burden in unit weight than colon ICs, and the microbial communities differed between the ICs from the cecum and colon. A more detailed comparison of the two microbiome groups showed that the abundance of potentially pathogenic bacteria increased in the cecum ICs. Our data suggest that the sepsis severity developed by perforation was associated with bacterial burden and increased abundance of potentially pathogenic bacteria in the cecum. Our findings first compared the differences in the lethality associated with the ICs of the cecum and colon, which pointed out that the site of perforation could help providers predict the severity of sepsis.