Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort

Background Invasive bacterial biofilms are implicated in colorectal cancer. However, their prevalence on histologically normal tissues and polyps is not well established, and risk factors of biofilms have not been previously investigated. Here we evaluated potential procedural and demographic risk f...

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Main Authors: Julia L. Drewes, Samara B. Rifkin, Madison McMann, Sara Glass, Emma Spence, Caroline R. Wensel, Abby L. Geis, Courtney Stevens, Joell J. Gills, Hao Wang, Linda M. Hylind, Gerard Mullin, David Kafonek, David Cromwell, Louis La Luna, Francis M. Giardiello, Cynthia L. Sears
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Gut Microbes
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Online Access:https://www.tandfonline.com/doi/10.1080/19490976.2025.2452233
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author Julia L. Drewes
Samara B. Rifkin
Madison McMann
Sara Glass
Emma Spence
Caroline R. Wensel
Abby L. Geis
Courtney Stevens
Joell J. Gills
Hao Wang
Linda M. Hylind
Gerard Mullin
David Kafonek
David Cromwell
Louis La Luna
Francis M. Giardiello
Cynthia L. Sears
author_facet Julia L. Drewes
Samara B. Rifkin
Madison McMann
Sara Glass
Emma Spence
Caroline R. Wensel
Abby L. Geis
Courtney Stevens
Joell J. Gills
Hao Wang
Linda M. Hylind
Gerard Mullin
David Kafonek
David Cromwell
Louis La Luna
Francis M. Giardiello
Cynthia L. Sears
author_sort Julia L. Drewes
collection DOAJ
description Background Invasive bacterial biofilms are implicated in colorectal cancer. However, their prevalence on histologically normal tissues and polyps is not well established, and risk factors of biofilms have not been previously investigated. Here we evaluated potential procedural and demographic risk factors associated with biofilm status using a cross-sectional observational cohort.Methods Histologically normal colonic biopsies from 2,051 individuals undergoing screening colonoscopy were evaluated for biofilm status using fluorescence in situ hybridization with oligonucleotide probes targeting bacterial 16S rRNA. Polyp tissues from 21 individuals were also examined. Procedural, demographic, and lifestyle predictors of bacterial scores were evaluated using multivariable proportional odds regression models.Results Procedural variables that negatively impacted bacterial scores and biofilm detection included smaller biopsy forcep size, physician, bowel preparation type, and shorter times from bowel preparation completion to colonoscopy. Lifestyle variables including greater alcohol and cigarette usage were associated with higher bacterial scores, while vigorous physical activity and diabetes mellitus were associated with lower bacterial scores. Bacterial scores on normal tissues were significantly higher in individuals with colorectal cancer but not polyps compared to dysplasia-free individuals. Direct examination of polyp tissues demonstrated similar bacterial burden and taxonomic composition compared to paired normal tissues, but polyps displayed enhanced bacterial invasion into crypts. Additionally, bacterial scores significantly correlated with increasing polyp size, suggesting co-evolution of polyps with bacterial invasion and biofilm status.Conclusions Colonic biofilms are highly dynamic ecosystems that associate with several other known risk factors for colorectal cancer. However, biofilm detection is impacted by multiple procedural factors.
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spelling doaj-art-643b3544e751451d8ecbbc894cecd6982025-01-18T16:55:31ZengTaylor & Francis GroupGut Microbes1949-09761949-09842025-12-0117110.1080/19490976.2025.2452233Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohortJulia L. Drewes0Samara B. Rifkin1Madison McMann2Sara Glass3Emma Spence4Caroline R. Wensel5Abby L. Geis6Courtney Stevens7Joell J. Gills8Hao Wang9Linda M. Hylind10Gerard Mullin11David Kafonek12David Cromwell13Louis La Luna14Francis M. Giardiello15Cynthia L. Sears16Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Gastroenterology, University of Michigan, Ann Arbor, MI, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USABloomberg-Kimmel Institute of Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Oncology, Sidney Kimmel Comprehensive Care Center, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USAGreen Spring Endoscopy, Lutherville, MD, USAMaryland Endoscopy Center, Towson, MD, USADigestive Disease Associates, Reading, Wyomissing, PA, USADepartment of Oncology, Sidney Kimmel Comprehensive Care Center, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USABackground Invasive bacterial biofilms are implicated in colorectal cancer. However, their prevalence on histologically normal tissues and polyps is not well established, and risk factors of biofilms have not been previously investigated. Here we evaluated potential procedural and demographic risk factors associated with biofilm status using a cross-sectional observational cohort.Methods Histologically normal colonic biopsies from 2,051 individuals undergoing screening colonoscopy were evaluated for biofilm status using fluorescence in situ hybridization with oligonucleotide probes targeting bacterial 16S rRNA. Polyp tissues from 21 individuals were also examined. Procedural, demographic, and lifestyle predictors of bacterial scores were evaluated using multivariable proportional odds regression models.Results Procedural variables that negatively impacted bacterial scores and biofilm detection included smaller biopsy forcep size, physician, bowel preparation type, and shorter times from bowel preparation completion to colonoscopy. Lifestyle variables including greater alcohol and cigarette usage were associated with higher bacterial scores, while vigorous physical activity and diabetes mellitus were associated with lower bacterial scores. Bacterial scores on normal tissues were significantly higher in individuals with colorectal cancer but not polyps compared to dysplasia-free individuals. Direct examination of polyp tissues demonstrated similar bacterial burden and taxonomic composition compared to paired normal tissues, but polyps displayed enhanced bacterial invasion into crypts. Additionally, bacterial scores significantly correlated with increasing polyp size, suggesting co-evolution of polyps with bacterial invasion and biofilm status.Conclusions Colonic biofilms are highly dynamic ecosystems that associate with several other known risk factors for colorectal cancer. However, biofilm detection is impacted by multiple procedural factors.https://www.tandfonline.com/doi/10.1080/19490976.2025.2452233Biofilmscolonoscopybowel preparationcolorectal cancerpolyps
spellingShingle Julia L. Drewes
Samara B. Rifkin
Madison McMann
Sara Glass
Emma Spence
Caroline R. Wensel
Abby L. Geis
Courtney Stevens
Joell J. Gills
Hao Wang
Linda M. Hylind
Gerard Mullin
David Kafonek
David Cromwell
Louis La Luna
Francis M. Giardiello
Cynthia L. Sears
Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
Gut Microbes
Biofilms
colonoscopy
bowel preparation
colorectal cancer
polyps
title Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
title_full Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
title_fullStr Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
title_full_unstemmed Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
title_short Epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
title_sort epidemiology of bacterial biofilms on polyps and normal tissues in a screening colonoscopy cohort
topic Biofilms
colonoscopy
bowel preparation
colorectal cancer
polyps
url https://www.tandfonline.com/doi/10.1080/19490976.2025.2452233
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