Preoperative gut microbiota depletion and metabolomic signatures predict postoperative pneumonia in patients with intracranial space-occupying lesions: a multi-omics prospective cohort study

By
Juan Chen
Zhiyu Li
Yewen Zhan
Qianqian Tan
Jin Li
Hong Pu
June 16, 2026
0 min

Frontiers In Immunology

Overview

This study identifies preoperative gut microbiota depletion and specific metabolomic profiles as significant predictors of postoperative pneumonia (POP) in patients undergoing surgery for intracranial lesions. The findings suggest that monitoring these factors could enhance risk stratification and intervention strategies.

Background

Postoperative pneumonia (POP) is a critical complication in neurosurgery, significantly impacting recovery and mortality rates. Understanding the role of gut microbiota and metabolic profiles in predicting POP could lead to improved preoperative assessments and targeted interventions. The gut-lung axis theory provides a framework for exploring these relationships, emphasizing the need for innovative predictive models in surgical care.

Data Highlights

Finding	Details
Patient Enrollment	50 patients with intracranial lesions
Microbial Diversity	Reduced across all groups post-surgery
Roseburia Depletion	Significant preoperative depletion in POP patients
Metabolic Deficiency	Impaired fructose and mannose metabolism in POP group
Predictive Model AUC	1.0 for top 10 preoperative metabolites

Key Findings

Preoperative depletion of Roseburia is significantly associated with POP.
Patients who developed POP exhibited a preoperative metabolic deficiency state.
Microbial diversity decreased post-surgery across all patient groups.
1-methylnicotinamide levels positively correlated with Roseburia abundance.
A metabolic signature of the top 10 metabolites can predict POP with high accuracy.

Clinical Implications

Monitoring preoperative gut microbiota and metabolic profiles may allow for early identification of patients at high risk for postoperative pneumonia. This approach could facilitate targeted interventions to improve surgical outcomes and reduce morbidity associated with POP.

Conclusion

The study underscores the importance of gut microbiota and metabolic health in predicting postoperative pneumonia, suggesting that integrating these factors into preoperative assessments could enhance patient care in neurosurgery.