Metabolism gene signatures and surgical site infections in abdominal surgery

Int J Surg. 2015 Feb;14:67-74. doi: 10.1016/j.ijsu.2015.01.009. Epub 2015 Jan 16.


Introduction: Surgical site infections (SSI) represent a significant cause of morbidity in abdominal surgery. The objective of this study was to determine the gene expression signature in subcutaneous tissues in relation to SSI.

Methods: To determine differences in gene expression, microarray analysis were performed from bulk tissue mRNA of subcutaneous tissues prospectively collected in 92 patients during open abdominal surgery. 10 patients (11%) developed incisional (superficial and deep) SSI.

Results: Preoperative risk factors in patients with SSI were not significantly different from those in patients without wound infections. 1025 genes were differentially expressed between the groups, of which the AZGP1 and ALDH1A3 genes were the highest down- and upregulated ones. Hierarchical clustering demonstrated strong similarity within the respective groups (SSI vs. no-SSI) indicating inter-group distinctness. In a functional classification, genes controlling cell metabolism were mostly down-regulated in subcutaneous tissues of patients that subsequently developed SSI.

Conclusion: Altered expression of metabolism genes in subcutaneous tissues might constitute a risk factor for postoperative abdominal SSI.

Keywords: ALDH1A3; AZGP1; Cellular metabolism; Subcutaneous tissue; Surgical site infection.

MeSH terms

  • Abdomen
  • Adipokines
  • Adult
  • Aged
  • Aged, 80 and over
  • Aldehyde Oxidoreductases / metabolism
  • Aminohydrolases / metabolism
  • Carrier Proteins / metabolism
  • Digestive System Surgical Procedures
  • Female
  • Formate-Tetrahydrofolate Ligase / metabolism
  • Glycoproteins / metabolism
  • Humans
  • Immunohistochemistry
  • Male
  • Methylenetetrahydrofolate Dehydrogenase (NADP) / metabolism
  • Middle Aged
  • Multienzyme Complexes / metabolism
  • Postoperative Period
  • Subcutaneous Tissue / metabolism
  • Surgical Wound Infection / genetics*
  • Surgical Wound Infection / metabolism
  • Tissue Array Analysis
  • Transcriptome*
  • Young Adult


  • AZGP1 protein, human
  • Adipokines
  • Carrier Proteins
  • Glycoproteins
  • Multienzyme Complexes
  • formyl-methenyl-methylenetetrahydrofolate synthetase
  • Aldehyde Oxidoreductases
  • aldehyde dehydrogenase (NAD(P)+)
  • Methylenetetrahydrofolate Dehydrogenase (NADP)
  • Aminohydrolases
  • Formate-Tetrahydrofolate Ligase