Metagenomic Analysis Reveals Dynamic Changes of Whole Gut Microbiota in the Acute Phase of Intensive Care Unit Patients.
Metagenomic Analysis Reveals Dynamic Changes of Whole Gut Microbiota in the Acute Phase of Intensive Care Unit Patients.
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DOI：
10.1007/s10620-015-4011-3
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发表时间：
2016-06
影响因子：
3.1
通讯作者：
Shimazu T
中科院分区：
文献类型：
--
作者：
Ojima M;Motooka D;Shimizu K;Gotoh K;Shintani A;Yoshiya K;Nakamura S;Ogura H;Iida T;Shimazu T
针对 16S rRNA 基因的宏基因组分析使得表征肠道中包含的大量微生物成为可能。本研究的目的是评估重症监护病房 (ICU) 患者入院后急性期肠道微生物群的变化。这项前瞻性观察队列研究调查了一家大型城市三级转诊医院单个 ICU 收治的 12 名患者。所有患者入院时均接受机械通气。入院后第 1-2 天、2-4 天、5-8 天和 7-10 天收集患者的粪便样本。从粪便样本中提取 DNA，并进行 16S rRNA 深度测序来监测肠道变化。属于厚壁菌门或拟杆菌门的细菌在每个样品中占主导地位。我们观察到拟杆菌门和厚壁菌门的百分比在研究期间发生显着变化（p < 0.05）。 6 名死亡患者中，有 4 名的拟杆菌门与厚壁菌门的比率（B/F 比率）>10，而 6 名死亡患者中，只有 1 名的 B/F 比率 <0.10。没有幸存者的 B/F 比率 >10 或 <0.10。死亡患者和幸存者之间的 B/F 比值存在统计学差异 (p = 0.022)。 通过高通量 DNA 测序鉴定了 ICU 患者急性期肠道菌群门水平的动态变化。肠道微生物群的极度失衡可能与危重患者的预后有关。
Metagenomic analysis targeting the 16S rRNA gene has made it possible to characterize the vast array of microorganisms contained in the gut. The purpose of this study was to evaluate how gut microbiota change in intensive care unit (ICU) patients in the acute phase after admission. This prospective observational cohort study investigated 12 patients admitted to a single ICU of a large urban tertiary referral hospital. All patients were mechanically ventilated on admission. Fecal samples were collected from patients on days 1–2, 2–4, 5–8, and 7–10 after admission. DNA was extracted from fecal samples, and 16S rRNA deep sequencing was performed to monitor gut changes. Bacteria belonging to the phyla Firmicutes or Bacteroidetes were predominant in each sample. We observed serial dynamic changes in the percentages of Bacteroidetes and Firmicutes that were significantly altered during study period (p < 0.05). A ratio of Bacteroidetes to Firmicutes (B/F ratio) of >10 was seen in four of the six patients who died, whereas a B/F ratio of <0.10 was seen in only one of the six deaths. None of the survivors had a B/F ratio of >10 or <0.10. There was a statistical difference in the B/F ratio between the dead patients and survivors (p = 0.022). Dynamic changes in gut microbiota at the phylum level of ICU patients during the acute phase were identified by high-throughput DNA sequencing. An extreme imbalance in gut microbiota may be associated with prognosis in critically ill patients.