Microbiota-based biomarkers of infection risk in patients undergoing vascular endograft implantation: a pilot study.

Background: Healthcare-associated infections (HAIs) remain a critical issue for healthcare systems worldwide, contributing significantly to increased morbidity, mortality, and healthcare costs. Post-surgical and device-associated HAIs are particularly concerning due to their severe and potentially fatal clinical outcomes. Although it remains largely unexplored, the interaction between host, implanted device, and human microbiota is increasingly recognized as a potential factor in HAI onset. Methods: In this context, the present project aims to investigate-through 16S rRNA gene sequencing-the potential predictive and pathogenetic role of the skin and oral microbiota in patients undergoing vascular endografts (VEGs) implantation. Microbial profiles of patients who developed HAIs (HAI group) were compared with those who did not experience any post-surgical infectious complications (NoHAI group) to identify risk biomarkers, dysbiotic microbial patterns, and potential evolutionary trajectories that predispose to the HAIs onset. Results: Oral samples from HAI patients showed reduced microbial diversity (Shannon index, p-value = 0.597), whereas skin samples showed a significantly higher diversity (p-value = 0.023) compared with NoHAI patients. Furthermore, specific taxa emerged as potential indicators of HAIs susceptibility, including the phylum Firmicutes D (p-value < 0.001), the genera Staphylococcus (p-value = 0.011) and Haemophilus D (p-value = 0.036), and the species Prevotella denticola (p-value = 0.01) and Streptococcus mutans (p-value = 0.005). Conclusion: These results provide preliminary insights into the microbiological dynamics that may predispose patients to the onset of infections. Although further validation on larger and more diverse surgical populations is needed, these microbial signatures could represent promising targets for future pre-operative risk stratification and personalized preventive strategies in surgical patients.