Bariatric surgery in obese patients changes the composition of the intestinal flora

In people with morbid obesity who undergo a crash diet, the diversity of the intestinal flora (microbiota) is temporarily reduced. When these patients subsequently undergo bariatric surgery (stomach reduction), the intestinal flora recovers over time with a composition similar to that found directly 1 week after the surgery. According to investigators, such a "healthy" composition of the intestinal flora may contribute to weight loss in people with morbid obesity after bariatric surgery.

Bariatric surgery is the only proven effective long-term treatment in people with morbid obesity. It is known that people with morbid obesity have a different intestinal flora composition than people with a normal weight. However, details of these differences and their interpretation have not been properly investigated.


Looking for the causes of pain in osteoarthritis

People with knee osteoarthritis who have a lot of pain have more nerve endings in their knee than people with osteoarthritis who have little pain. This is the conclusion of a study by Dr. Niels Eijkelkamp of UMC Utrecht. In new research, financed by ReumaNederland, he will look for the cause: the connection between inflammation and the nervous system.

Dr. Niels Eijkelkamp (LTI) is one of the top researchers in the field of osteoarthritis pain. His mission is to better understand the pain in osteoarthritis and to be able to treat it well. Three years ago, his first research was started, financed by ReumaNederland.


Nursing of carriers of the ESBL bacteria is safe in multiple-bed rooms

Carriers of the highly resistant ESBL-producing Enterobacteriaceae (ESBL-E) can be nursed in a hospital together with wardmates in a multiple-bed room if contact precautions are taken without without additional risk of infection. Dutch research, coordinated from Amphia Hospital and UMC Utrecht, has shown that the risk of infection by nursing in a multiple-bed room is not higher as compared to a single-bed room.

To prevent the spread of highly resistant bacteria such as the ESBL-producing Enterobacteriaceae (ESBL stands for 'extended-spectrum beta-lactamase') in hospitals, infection prevention guidelines now recommend that contact precautions be applied to patients that are carrier of this bacterium, preferably with nursing in a single-bed room. However, the availability of single-bed rooms is limited in many hospitals. In addition, studies are ambiguous on the added value of single-bed rooms in controlling the spread of resistant bacteria.

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Researchers from National Institute for Public Health and the Environment, Utrecht University, UMC Utrecht, the Animal Health Service and Wageningen Bioveterinary Research (all members of the ESBLAT consortium) have previously shown that ESBL antimicrobial resistance is common in humans, animals, food and the environment. However, ESBL types in humans were found to differ from those in animals and food. The most important source of contamination for humans remained unknown until now. New research published in Lancet Planetary Health shows that humans themselves are the most important source of ESBL antibiotic resistance.

According to a mathematical model, human-to-human transmission is responsible for more than 60 percent of all humans that are carriers of ESBLs in their intestines. The contribution of food was estimated at around 19 percent, contact with pets at 8 percent, hobby/recreational contact with livestock at 4 percent and swimming in surface water and contact with wild birds at 3 percent. This means that ESBLs are mainly transferred between people and that people get ESBLs to a lesser extent through animals, animal food and the environment. These results indicate that ESBL transmission and contamination has a true One Health character. The results also show that continuous exposure from different sources such as humans, animals, food and the environment maintains the occurrence of ESBLs in the population.

Human-to-human transfer is the main source of ESBL antibiotic resistance


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