Gut microbiota profiles in critically ill patients, potential biomarkers and risk variables for sepsis.
Gut microbiota profiles in critically ill patients, potential biomarkers and risk variables for sepsis.
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DOI：
10.1080/19490976.2019.1707610
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发表时间：
2020-11-09
期刊：
影响因子：
12.2
通讯作者：
Benítez-Paéz A
中科院分区：
文献类型：
--
作者：
Agudelo-Ochoa GM;Valdés-Duque BE;Giraldo-Giraldo NA;Jaillier-Ramírez AM;Giraldo-Villa A;Acevedo-Castaño I;Yepes-Molina MA;Barbosa-Barbosa J;Benítez-Paéz A
重症患者的生理状态不稳定，最近的研究表明，肠道微生物群可能与此类患者在ICU期间的健康下降有关。本研究旨在评估伴和不伴败血症的重症患者的肠道微生物群，并确定其对结局变量的影响，如医疗并发症，ICU停留时间和死亡率。进行了一项多中心研究，共采集了155例患者入院时和ICU住院期间的250份直肠周围拭子。通过对16 S rRNA基因的V3-V4高变区进行测序来评估肠道微生物群。使用线性混合模型将微生物群数据与40多个临床和人口统计学变量相结合，以检测协变量并最大限度地减少混杂因素的影响。我们发现，ICU脓毒症患者的微生物群中与炎症密切相关的微生物丰度增加，如副拟杆菌属、梭杆菌属和嗜胆汁菌属。女性性别和年龄增长可能会增加败血症的风险，这可能是因为她们的一些微生物群特征。我们还证明了在ICU停留期间微生物多样性的显著损失。与此同时，我们检测到致病物种的丰度，如肠球菌属，在死亡的脓毒症患者中差异性增加，表明这些物种是ICU住院期间监测的潜在生物标志物。我们得出结论，特定的肠道微生物群特征可以预测ICU患者的脓毒症发展。我们提出了潜在的生物标志物，用于评价ICU患者的临床管理。
Critically ill patients are physiologically unstable and recent studies indicate that the intestinal microbiota could be involved in the health decline of such patients during ICU stays. This study aims to assess the intestinal microbiota in critically ill patients with and without sepsis and to determine its impact on outcome variables, such as medical complications, ICU stay time, and mortality. A multi-center study was conducted with a total of 250 peri-rectal swabs obtained from 155 patients upon admission and during ICU stays. Intestinal microbiota was assessed by sequencing the V3-V4 hypervariable regions of the 16S rRNA gene. Linear mixed models were used to integrate microbiota data with more than 40 clinical and demographic variables to detect covariates and minimize the effect of confounding factors. We found that the microbiota of ICU patients with sepsis has an increased abundance of microbes tightly associated with inflammation, such as Parabacteroides, Fusobacterium and Bilophila species. Female sex and aging would represent an increased risk for sepsis possibly because of some of their microbiota features. We also evidenced a remarkable loss of microbial diversity, during the ICU stay. Concomitantly, we detected that the abundance of pathogenic species, such as Enterococcus spp., was differentially increased in sepsis patients who died, indicating these species as potential biomarkers for monitoring during ICU stay. We concluded that particular intestinal microbiota signatures could predict sepsis development in ICU patients. We propose potential biomarkers for evaluation in the clinical management of ICU patients.
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影响因子：
14.9
作者：
Klindworth A;Pruesse E;Schweer T;Peplies J;Quast C;Horn M;Glöckner FO
通讯作者：
Glöckner FO
影响因子：
3.4
作者：
Heneghan, Aaron F.;Pierre, Joseph F.;Kudsk, Kenneth A.
通讯作者：
Kudsk, Kenneth A.
影响因子：
5
作者：
D'Argenio, Valeria;Salvatore, Francesco
通讯作者：
Salvatore, Francesco
影响因子：
4.6
作者：
Kverka, M.;Zakostelska, Z.;Tlaskalova-Hogenova, H.
通讯作者：
Tlaskalova-Hogenova, H.
影响因子：
12.2
作者：
Fragiadakis, Gabriela K.;Smits, Samuel A.;Sonnenburg, Justin L.
通讯作者：
Sonnenburg, Justin L.