Gut flora and synbiotics therapy in patients with severe SIRS

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The gut is considered an important target organ of injury following severe insult such as sepsis, trauma, and shock. Synbiotics therapy is a combination with probiotics and prebiotics. We quantitatively evaluated changes in the gut microflora and environment in patients with severe SIRS, examined the effects of synbiotic treatment on clinical course, and evaluated the limitation of synbiotic treatment on gut dysmotility.1) The gut flora and environment are significantly altered in patients with severe SIRS. Analysis of fecal flora confirmed that patients with severe SIRS showed significantly lower total anaerobic bacterial counts, in particular, 2-4 log units fewer beneficial Bifidobacterium and Lactobacillus and 2 log units more pathogenic Staphylococcus and Pseudomonas group counts than did healthy volunteers. Concentrations of total fecal organic acids, in particular, beneficial short-chain fatty acids such as acetic acid, propionic acid, and butyric acid, were significantly decreas … More ed in the patients.2) Synbiotics maintain the gut flora and environment in patients with severe SIRS and significantly reduce the incidence of septic complications. The incidences of infectious complications in patients with severe SIRS were significantly lower in the synbiotics group than in the control group(enteritis, 7%vs. 46%, pneumonia, 20% vs. 52%,and bacteremia, 10%vs. 33%, respectively). These beneficial effects of synbiotics in the present study may be due to improved gut flora, increased short-chain fatty acids.3) In SIRS patients with synbiotic therapy(50cases), intestinal dymotility patients(5 cases) all had deterioration in their gut flora, caused bacteremia, and were mortal.As a result, the deterioration of gut flora were related with septic complications and mortality. Synbiotics could maintain the gut flora and protect the critically ill patients from infectious complications. Further study is needed to clarify the mechanisms by which synbiotics decrease septic complications in patients with SIRS. Less