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

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Lankelma , J M , van Vught , L A , Belzer , C , Schultz , M J , van der Poll , T , de Vos , W M & Wiersinga , W J 2017 , ' Critically ill patients demonstrate large interpersonal variation in intestinal microbiota dysregulation : a pilot study ' , Intensive Care Medicine , vol. 43 , no. 1 , pp. 59-68 . https://doi.org/10.1007/s00134-016-4613-z

Title: Critically ill patients demonstrate large interpersonal variation in intestinal microbiota dysregulation : a pilot study
Author: Lankelma, Jacqueline M.; van Vught, Lonneke A.; Belzer, Clara; Schultz, Marcus J.; van der Poll, Tom; de Vos, Willem M.; Wiersinga, W. Joost
Contributor: University of Helsinki, Medicum
Date: 2017-01
Language: eng
Number of pages: 10
Belongs to series: Intensive Care Medicine
ISSN: 0342-4642
URI: http://hdl.handle.net/10138/174963
Abstract: 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. 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. 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. 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.
Subject: Gut microbiota
Critically ill
Intensive care unit
Antibiotics
Sepsis
INTENSIVE-CARE-UNIT
FECAL MICROBIOTA
GUT MICROBIOTA
OROPHARYNGEAL DECONTAMINATION
CLOSTRIDIUM-DIFFICILE
CELL TRANSPLANTATION
SEVERE SEPSIS
DIVERSITY
DEFINITIONS
MORTALITY
3111 Biomedicine
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