P465 Are patients with inflammatory bowel disease more at risk of developing traveller's diarrhoea?

P465 Are patients with inflammatory bowel disease more at risk of developing traveller's diarrhoea?

S194 P464 Dysbiosis in mucosally adherent microbiota at surgery and in post-endoscopic recurrence at 6 and 12 months a longitudinal prospective evalua...

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S194 P464 Dysbiosis in mucosally adherent microbiota at surgery and in post-endoscopic recurrence at 6 and 12 months a longitudinal prospective evaluation in Crohn’s disease A. Murugananthan1 *, P. Tozer1 , D. Bernardo1 , A. Hart2 , S. Knight1 , K. Whelan3 , H.O. Al-Hassi1 , N. Arebi2 . 1 Antigen Presentation Research Group, Imperial College, London, United Kingdom, 2 St Mark’s Hospital, Department of Gastroenterology, London, United Kingdom, 3 King’s College Hospital, London, United Kingdom Background: Alterations of gut microbiota (dysbiosis) are involved in Crohn’s Disease (CD) pathogenesis. We aimed to study whether altered balance of bacterial species is associated with postoperative CD endoscopic recurrence. Methods: Samples were collected from inflamed and noninflamed surgically resected small bowel in CD patients at ileo-caecal resection (ICR). The patients were followed longitudinally and colonoscopy was performed at 6 and 12 months. Biopsies from the neo-terminal ileum were collected and endoscopic recurrence graded by Rutgeerts score (RS). Samples were hybridised with oligonucleotide probes targeting the microbial 16S rRNA of panbacteria, Escherichia coli, Bacteroides Prevotella, Faecalibacterium prausnitzii, Clostridium coccoides, Eubacterium rectale and bifidobacteria. The hybridised mucosa associated microbiota were identified and quantified. Endoscopic recurrence was classified as normal/mild (Rutgeert score {RS} i1) or severe (RS i2). Results: Fifteen patients underwent ICR (10 female). Nine patients had clinical risk factors for recurrence (6 smokers, 4 with fistulating disease and 2 with recurrent resection multiple risk factors present in 3 patients). High-risk patients received azathioprine post operatively. In surgical specimens, mucosally adherent Escherichia coli 1531 numbers were higher in inflamed compared with non-inflamed SB (Paired samples, p = 0.0015). No differences were noted with other 16S rRNA probes. Eleven patients underwent 6-month and 4 underwent 12-month colonoscopies. Patients with Rutgeerts scores i2 had lower bifidobacteria numbers compared with patients with scores i1 both at 6 months (p = 0.023) and overall (p = 0.026). Conclusions: Mucosally adherent Escherichia coli are prevalent in pre-operative inflamed mucosa. Post-operative endoscopic recurrence was associated with lower numbers of protective bifidobacteria. These differences in microbiota implicate a potentially diverse and dynamic bacterial profile with progressive inflammation in CD. P465 Are patients with inflammatory bowel disease more at risk of developing traveller’s diarrhoea? V. Fenech1 *, L. Callus1 , N.P. Delicata1 , C. Azzopardi1 , J. Muscat1 , R. Pullicino1 , N. Azzopardi2 , P. Ellul1 . 1 Mater Dei hospital, Malta, 2 Mater Dei Hopsital, Gastroenterology Department, Msida, Malta Background: It is unknown if IBD patients are at higher risk for acquiring traveller’s diarrhoea (TD). Furthermore, travellers being treated with immunomodulators (IM) could be at greater risk of acquiring food and water-borne infections. Our aim was to determine if patients with IBD are at a higher risk of acquiring TD than healthy controls. Methods: A retrospective case control study was performed among adult IBD travellers with their travelling companions serving as matched controls with comparable exposure to infection. IBD patients (pts) were identified through our database. Pts were contacted and if they fulfilled the above criteria and had travelled in the previous 12 months were then enrolled. Data on symptoms of infectious diseases were recorded by using a structured questionnaire and interview. The clinical case notes were reviewed.

Poster presentations Results: In total we had 71 IBD pts (male-30). Their mean age was 41.8 years (17 68 years). 37 pts (52%) had UC. 34 pts had Crohn’s disease (48%). They were matched by healthy controls in terms of countries, places visited and duration of travel. The latter varied from 3 60 days (mean 9.62 days). They visited Europe 88.7%, North America 4.2% and Asia 7.1%. 11 IBD pts (15.5%) developed TD while only 1 healthy control had TD (1.4%). Statistical analysis using Chi-square test for independence (with Yates Continuity Correction) indicated significant association between TD and IBD pts (p = 0.007). The healthy control who developed TD travelled with an IBD patient who also developed TD. Of the 11 IBD pts who developed TD, 8 (72%) were receiving IM. The other 3 pts were having 5-ASA medications. In the whole group 49 pts (69%) were having IM. 85.3% of IBD pts were compliant with their IBD medications. 6 pts (8.5%) had an exacerbation of their disease when abroad and needed treatment modification. Of those pts who had an exacerbation only 1 pt was uncompliant with the IBD drugs. Conclusions: Our study demonstrated that IBD pts are more at risk of developing TD than their healthy controls (p = 0.007). There was no significant difference between the proportion of pts on IM who developed TD (16.3%) versus those not have any IM (13.6%). Thus, patients with IBD should pay greater attention to precautions regarding food and water than normal. They should be well educated on TD, may be advised to carry appropriate antibiotics for empirical self-treatment and seek early medical advice if symptoms do not improve. P466 Endogenous production of antibiotics by mesenchymal stem cells and the potential value in Crohn’s fistula healing L. Meran1 *, M. Garavaglia2 , B. Richards3 , S. Heeb2 , W. Ashraf3 , F. Rose4 , R. Bayston3 , K. Shakesheff4 , C. Hawkey1 . 1 Nottingham Digestive Diseases Centre, Nottingham University Hospitals, Nottingham, United Kingdom, 2 School of Molecular Medical Sciences, Nottingham University, Nottingham, United Kingdom, 3 Biomaterials Related Infection Group, Nottingham University Hospitals, Nottingham, United Kingdom, 4 Tissue Engineering, STEM, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, United Kingdom Background: Potent effects of human mesenchymal stem cells (MSCs) on innate and adaptive immune responses have been demonstrated in in-vitro studies and animal models, encouraging further investigations into their value in clinical trials. Studies of MSCs in fistula healing have emphasised immunosuppressive mechanisms of action however, there has been little focus on their antibacterial activity in this setting. Since infection of the fistula tract predisposes to persistence of symptoms, this report focuses on the antibacterial effects of MSCs against Adherent Invasive Escherichia coli (AIEC), reference strain LF82. Methods: Cultured human bone marrow derived MSCs were plated at a density of 5×104 cells per square centimeter in 24 well plates and allowed to adhere overnight. Confluent MSCs were preincubated for 1 day with fresh culture medium alone or medium supplemented with 1 ng/ml TNFa. Cells of passage numbers 4 9 were co-cultured with a calculated 300 Colony Forming Units (CFU) of AIEC strain LF82 and incubated for 6 hours in a humidified CO2 incubator. Aliquots of the infected medium were taken from each well and plated on LB-agar plates and colonies were counted after overnight incubation. Comparisons were made with aliquots from inoculated wells containing cells that were pre-stimulated with TNFa, in addition to wells that did not contain mesenchymal stem cells. Data analyses were performed using the SPSS statistical package (version 19.0).