Dysbiosis of Gut Microbiome in Neurocritically Ill Patients in Intensive Care: Systematic Review

Abstract

Background: The human microbiome is a community of microorganisms that live in symbiosis with humans. This relationship between humans and the microbiome affects the physiology of health and disease, but not many studies have evaluated the condition of the digestive microbiome in neurology critical condition patients and its changes. This study aims to describe the microbiome characteristics of neurological patients in the intensive care unit. Methods: We conducted a systematic literature review of the relationship between the microbiome and neurology patients admitted to the intensive care unit by searching MEDLINE/PubMed, the Cochrane Database for Systematic Reviews, and Google Scholar for articles in English published through 13 June 2022. Results: There is a change in the normal flora pattern in neurological patients who are treated in the intensive care unit. The decrease in the number of colonies occurred in commensal flora bacteria and an increase in pathogenic bacteria such as Enterobacteriaceae. Discussion: The overgrowth of opportunistic pathogens suggests dysbiosis in patients with neurocritical conditions. This is thought to be correlated with the gut-brain axis relationship. This dysbiosis evaluation can be used to provide targeted microbiome therapy and to assess the risk of clinical deterioration and death in neurologic patients in intensive care. Conclusion: This study reported a significant difference between the composition of the gut microbiota in neurology patients in intensive care and the healthy population. The magnitude of this dysbiosis increases during hospitalization in the intensive care unit and has an impact on patient outcomes. Intestinal microbiota analysis is expected to provide an overview of targeted microbial therapy and predict future patient outcomes. Keywords: Neurocritical patients, intensive care, microbiome