Marked Changes in Gut Microbiota in Cardio-Surgical Intensive Care Patients: A Longitudinal Cohort Study

Aardema, Heleen; Lisotto, Paola; Kurilshikov, Alexander; Diepeveen, Janneke R. J.; Friedrich, Alex; Sinha, Bhanu; Smet, Anne Marie G. A. de; Harmsen, Hermie J. M.

doi:10.3389/fcimb.2019.00467

Cited by 41 publications

(47 citation statements)

References 37 publications

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“…Interestingly, CIP controls also showed reduced alpha diversity, highlighting a potential lasting effect of the ICU stay itself on microbial diversity even more than one year after the intensive care treatment. In contrast, data from Aardema et al suggest a faster recovery of the microbiome in their cohort of ICU patients after cardiac surgery, but the mean ICU stay of these patients was only one day [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Further on, they receive multiple medications including antibiotics, antiviral and antifungal therapies and enteric or parenteral nutrition. That all these interventions together with the underlying critical illness alter the microbiome on different body sites has been shown recently, as well as that these changes may trigger hospital-acquired infections, sepsis, multi-organ failure, energy homeostasis disturbance, muscle wasting and cachexia [ 10 , 12 , 13 , 44 , 66 , 67 , 68 ]. One reason for this may be the slower bowel transit time in critically ill patients caused by electrolyte and glucose disturbances as well as by therapeutics like sedatives and opiates [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In the last three years, data about the microbial changes of the gut and of other locations of the human body in critically ill patients has emerged [ 10 , 11 , 12 , 13 ]. Data about the long-term effects of an ICU stay on the gut microbiome are, however, scarce [ 13 ]. Microbiological bile analysis from patients with SC-CIP and primary sclerosing cholangitis (PSC) showed an altered microbiological profile in these two groups, with predominance of drug-resistant organisms in the bile of SC-CIP [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study

et al. 2020

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Secondary sclerosing cholangitis in critically ill patients (SC-CIP) occurs after long-term intensive care treatment. This study aimed to assess the gut–liver axis in SC-CIP. Stool microbiome composition, gut permeability, bacterial translocation and serum bile acid profiles of 18 SC-CIP patients compared to 11 patients after critical illness without liver disease (CIP controls), 21 patients with cirrhosis and 21 healthy controls were studied. 16S rDNA was isolated from stool and sequenced using the Illumina technique. Diamine oxidase, zonulin, soluble CD14 (sCD14) and lipopolysaccharide binding protein were measured in serum and calprotectin in stool. Serum bile acids were analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS). Reduced microbiome alpha diversity and altered beta diversity were seen in SC-CIP, CIP controls and cirrhosis compared to healthy controls. SC-CIP patients showed a shift towards pathogenic taxa and an oralization. SC-CIP, CIP controls and cirrhotic patients presented with impaired gut permeability, and biomarkers of bacterial translocation were increased in SC-CIP and cirrhosis. Total serum bile acids were elevated in SC-CIP and cirrhosis and the bile acid profile was altered in SC-CIP, CIP controls and cirrhosis. In conclusions, observed alterations of the gut–liver axis in SC-CIP cannot solely be attributed to liver disease, but may also be secondary to long-term intensive care treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study

et al. 2020

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“…Critical illness requiring treatment in an intensive care unit (ICU) results in rapid and profound alterations to the gastrointestinal microflora [1,2]. Microbiota depletion and diversity loss are associated with adverse outcomes including prolonged hospital stay, nosocomial infections and increased mortality [2][3][4]. The reintroduction of commensal bacteria using strain-specific oral probiotic therapy may mitigate these adverse effects [5,6].…”

Section: Introductionmentioning

confidence: 99%

Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: the randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT)

et al. 2021

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In adults requiring treatment in an intensive care unit, probiotic therapy using Lactobacillus plantarum 299v may reduce nosocomial infection. The aim of this study was to determine whether early and sustained L. plantarum 299v therapy administered to adult ICU patients increased days alive and at home. Methods: A multicentre, parallel group, placebo-controlled, randomised clinical trial was conducted. Adult patients within 48 h of intensive care admission and expected to require intensive care beyond the day after recruitment were eligible to participate. L plantarum 299v or placebo were administered immediately after enrolment and continued for 60 days. The primary outcome was days alive and out of hospital to Day 60 (DAOH 60). Secondary outcomes included nosocomial infections. Results: The median [interquartile range (IQR)] number of DAOH 60 in the probiotic (n = 110) and placebo group (n = 108) was 49.5 (IQR 37.0-53.0) and 49.0 (IQR 43.8-53.0) respectively, between-group difference of 0.0 [95% confidence interval (CI) − 6.10 to 7.1, P = 0.55]. Nosocomial infection occurred in 8 (7.3%) and 5 (4.6%) of the probiotic and placebo group participants, respectively, odds ratio 1.62 (95% CI 0.51-5.10), P = 0.57. There were no serious, or probiotic-associated adverse events. Conclusion: Early and sustained untargeted administration of probiotic therapy with Lactobacillus plantarum 299v to adult patients admitted to the ICU is safe, but not associated with improved patient outcomes.

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From heart to gut: Exploring the gut microbiome in congenital heart disease

Liu,

Huang,

et al. 2023

iMeta

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Congenital heart disease (CHD) is a prevalent birth defect and a significant contributor to childhood mortality. The major characteristics of CHD include cardiovascular malformations and hemodynamical disorders. However, the impact of CHD extends beyond the circulatory system. Evidence has identified dysbiosis of the gut microbiome in patients with CHD. Chronic hypoxia and inflammation associated with CHD affect the gut microbiome, leading to alterations in its number, abundance, and composition. The gut microbiome, aside from providing essential nutrients, engages in direct interactions with the host immune system and indirect interactions via metabolites. The abnormal gut microbiome or its products can translocate into the bloodstream through an impaired gut barrier, leading to an inflammatory state. Metabolites of the gut microbiome, such as short‐chain fatty acids and trimethylamine N‐oxide, also play important roles in the development, treatment, and prognosis of CHD. This review discusses the role of the gut microbiome in immunity, gut barrier, neurodevelopment, and perioperative period in CHD. By fostering a better understanding of the cross‐talk between CHD and the gut microbiome, this review aims to contribute to improve clinical management and outcomes for CHD patients.

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Marked Changes in Gut Microbiota in Cardio-Surgical Intensive Care Patients: A Longitudinal Cohort Study

Cited by 41 publications

References 37 publications

Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study

Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study

Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: the randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT)

From heart to gut: Exploring the gut microbiome in congenital heart disease

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