Critically ill patients demonstrate large interpersonal variation in intestinal microbiota dysregulation: a pilot study

Purpose The intestinal microbiota has emerged as a virtual organ with essential functions in human physiology. Antibiotic-induced disruption of the microbiota in critically ill patients may have a negative influence on key energy resources and immunity. We set out to characterize the fecal microbiot...

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Vydáno v:Intensive care medicine Ročník 43; číslo 1; s. 59 - 68
Hlavní autoři: Lankelma, Jacqueline M., van Vught, Lonneke A., Belzer, Clara, Schultz, Marcus J., van der Poll, Tom, de Vos, Willem M., Wiersinga, W. Joost
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2017
Springer
Springer Nature B.V
Témata:
Aged
Aged, 80 and over
Analysis
Anesthesiology
Anti-Bacterial Agents - adverse effects
Antibiotics
Biomarkers - analysis
Clinical outcomes
Critical Care Medicine
Critical Illness
Critically ill
Emergency Medicine
Feces
Feces - microbiology
Female
Firmicutes
Gastrointestinal Microbiome - drug effects
Gut microbiota
Humans
Infection
Intensive
Intensive care
Intensive care unit
Male
Medicine
Medicine & Public Health
Microbiota
Microbiota (Symbiotic organisms)
Middle Aged
Mortality
Netherlands
Nosocomial infections
Original
Pain Medicine
Patients
Pediatrics
Physiological aspects
Pilot Projects
Pneumology/Respiratory System
Prospective Studies
RNA
Sepsis
Sepsis - microbiology
Software
Netherlands
Gut microbiota
Sepsis
Antibiotics
Critically ill
Intensive care unit
ISSN:0342-4642, 1432-1238, 1432-1238
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Shrnutí:Purpose The intestinal microbiota has emerged as a virtual organ with essential functions in human physiology. Antibiotic-induced disruption of the microbiota in critically ill patients may have a negative influence on key energy resources and immunity. We set out to characterize the fecal microbiota composition in critically ill patients both with and without sepsis and to explore the use of microbiota-derived markers for clinical outcome measurements in this setting. Methods In this prospective observational cohort study we analyzed the fecal microbiota of 34 patients admitted to the intensive care unit. Fifteen healthy subjects served as controls. The fecal microbiota was phylogenetically characterized by 16S rRNA gene sequencing, and associations with clinical outcome parameters were evaluated. Results A marked shift in fecal bacterial composition was seen in all septic and non-septic critically ill patients compared with controls, with extreme interindividual differences. In 13 of the 34 patients, a single bacterial genus made up >50% of the gut microbiota; in 4 patients this was even >75%. A significant decrease in bacterial diversity was observed in half of the patients. No associations were found between microbiota diversity, Firmicutes/Bacteroidetes ratio, or Gram-positive/Gram-negative ratio and outcome measurements such as complications and survival. Conclusions We observed highly heterogeneous patterns of intestinal microbiota in both septic and non-septic critically ill patients. Nevertheless, some general patterns were observed, including disappearance of bacterial genera with important functions in host metabolism. More detailed knowledge of the short- and long-term health consequences of these major shifts in intestinal bacterial communities is needed.
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ISSN:0342-4642
1432-1238
1432-1238
DOI:10.1007/s00134-016-4613-z