Multi-Compartment Profiling of Bacterial and Host Metabolites Identifies Intestinal Dysbiosis and Its Functional Consequences in the Critically Ill Child

Wijeyesekera, Anisha; Wagner, Josef; Goffau, Marcus C. de; Thurston, Sarah; Sabino, Adilson Rodrigues; Zaher, Sara; White, Deborah; Ridout, Jenna; Peters, Mark; Ramnarayan, Padmanabhan; Branco, Ricardo Garcia; Török, M. Estée; Valla, Frédéric V.; Klein, Nigel; Frost, Gary; Parkhill, Julian; Holmes, Elaine; Pathan, Nazima

doi:10.1097/ccm.0000000000003841

Cited by 24 publications

(46 citation statements)

References 32 publications

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“…Studies conducted in mice have shown that gut bacteria alter the distribution of free amino acids in the gastrointestinal tract and affect the bioavailability of amino acids for the host 48 . When the gut microbiota is healthy (eubiotic status), a trophic network is maintained that is suitable for the fermentation of substances present in the intestine, but when the gut microbial balance is disrupted (dysbiotic status), this trophic network is disrupted and the community shows poor fermentation efficiency 49 . Thus, higher concentrations of amino acids in the intestine are thought to be the result of incomplete fermentation.…”

Section: Resultsmentioning

confidence: 99%

Longitudinal evaluation of fecal microbiota transplantation for ameliorating calf diarrhea and improving growth performance

et al. 2021

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Calf diarrhea is associated with enteric infections, and also provokes the overuse of antibiotics. Therefore, proper treatment of diarrhea represents a therapeutic challenge in livestock production and public health concerns. Here, we describe the ability of a fecal microbiota transplantation (FMT), to ameliorate diarrhea and restore gut microbial composition in 57 growing calves. We conduct multi-omics analysis of 450 longitudinally collected fecal samples and find that FMT-induced alterations in the gut microbiota (an increase in the family Porphyromonadaceae) and metabolomic profile (a reduction in fecal amino acid concentration) strongly correlate with the remission of diarrhea. During the continuous follow-up study over 24 months, we find that FMT improves the growth performance of the cattle. This first FMT trial in ruminants suggest that FMT is capable of ameliorating diarrhea in pre-weaning calves with alterations in their gut microbiota, and that FMT may have a potential role in the improvement of growth performance.

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Section: Resultsmentioning

confidence: 99%

Longitudinal evaluation of fecal microbiota transplantation for ameliorating calf diarrhea and improving growth performance

et al. 2021

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“…Recently published data suggest that altered gut microbiome in patients receiving broad‐spectrum antibiotics 47,48 may lead to malabsorption of nutrients and thereby contribute to EFI 49 …”

Section: Introductionmentioning

confidence: 99%

Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology

et al. 2020

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Enteral feeding intolerance (EFI) is a common feature in critically ill patients worldwide. However, there is no clear, widely agreed‐upon definition available, with various studies rarely using the same definition. The term EFI is frequently used to describe vomiting or large gastric residual volumes associated with enteral feeding as a result of gastroparesis/delayed gastric emptying. However, the syndrome of EFI may represent the consequence of various pathophysiological mechanisms, and this heterogeneity may explain varying associations with outcomes. In clinical practice, a pragmatic definition may be useful. A pragmatic definition of EFI is that a clinician has decided to reduce the amount of enteral nutrition specifically because features of gastrointestinal dysfunction appeared during enteral feeding. For research purposes, a more detailed definition of EFI is required to improve knowledge and explore interventions that may improve patient‐centered outcomes. The objective of this review is to summarize available evidence on existing definitions, pathophysiological mechanisms, and the clinical relevance of EFI in critically ill patients. Based on current knowledge, we propose a conceptual framework for a definition of EFI for a future consensus process.

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“…[ 1 2 3 ] Critical illness is considered one of the major environmental influences that can impact the gut environment. [ 4 ] It is associated with pathophysiological effects causing damage to the intestinal microbiome. These include ischemia, hypoxia and hypotension along with the iatrogenic effects of therapeutic agents and the lack of enteral feeds.…”

Section: Introductionmentioning

confidence: 99%

Nutrition and the gut microbiome during critical illness: A new insight of nutritional therapy

Zaher

2020

Saudi J Gastroenterol

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Changes in the microbiome in response to environmental influences can affect the overall health. Critical illness is considered one of the major environmental factors that can potentially influence the normal gut homeostasis. It is associated with pathophysiological effects causing damage to the intestinal microbiome. Alteration of intestinal microbial composition during critical illness may subsequently compromise the integrity of the intestinal epithelial barrier and intestinal mucosa absorptive function. Many factors can impact the microbiome of critically ill patients including ischemia, hypoxia and hypotension along with the iatrogenic effects of therapeutic agents and the lack of enteral feeds. Factors related to disease state and medication are inevitable and they are part of the intensive care unit (ICU) exposure. However, a nutritional intervention targeting gut microbiota might have the potential to improve clinical outcomes in the critically ill population given the extensive vascular and lymphatic links between the intestines and other organs. Although nutrition is considered an integral part of the treatment plan of critically ill patients, still the role of nutritional intervention is restricted to improve nitrogen balance. What is dismissed is whether the nutrients we provide are adequate and how they are processed and utilised by the host and the microbiota. Therefore, the goal of nutrition therapy during critical illness should be extended to provide good quality feeds with balanced macronutrient content to feed up the entire body including the microbiota and host cells. The main aim of this review is to examine the current literature on the effect of critical illness on the gut microbiome and to highlight the role of nutrition as a factor affecting the intestinal microbiome-host relationship during critical illness.

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Multi-Compartment Profiling of Bacterial and Host Metabolites Identifies Intestinal Dysbiosis and Its Functional Consequences in the Critically Ill Child

Abstract: Supplemental Digital Content is available in the text.

Cited by 24 publications

References 32 publications

Longitudinal evaluation of fecal microbiota transplantation for ameliorating calf diarrhea and improving growth performance

Longitudinal evaluation of fecal microbiota transplantation for ameliorating calf diarrhea and improving growth performance

Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology

Nutrition and the gut microbiome during critical illness: A new insight of nutritional therapy

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