Study of the gut microbiome as a novel target for prevention of hospital-associated infections in intensive
care unit patients

Elfiky, Suzan Ahmed; Ahmed, Saad; Elmenshawy, Ahmed; Sultan, Gehad Mahmoud; Asser, Sara

doi:10.4266/acc.2022.01116

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…3 b, c). Loss of gut microbiome diversity in the critically ill is linked with depletion of short-chain fatty acid biosynthesis, conferring an increased risk of developing hospital-acquired infections [ 4 , 5 , 44 ]. Patients who received anaerobic antibiotic coverage in the ICU had increased concentration of Enterococci in their stool, which translated into higher numbers of organ failures and mortality rates [ 13 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Safety, feasibility, and impact on the gut microbiome of kefir administration in critically ill adults

Gupta,

Rajendraprasad,

Ozkan

et al. 2024

BMC Med

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Background Dysbiosis of the gut microbiome is frequent in the intensive care unit (ICU), potentially leading to a heightened risk of nosocomial infections. Enhancing the gut microbiome has been proposed as a strategic approach to mitigate potential adverse outcomes. While prior research on select probiotic supplements has not successfully shown to improve gut microbial diversity, fermented foods offer a promising alternative. In this open-label phase I safety and feasibility study, we examined the safety and feasibility of kefir as an initial step towards utilizing fermented foods to mitigate gut dysbiosis in critically ill patients. Methods We administered kefir in escalating doses (60 mL, followed by 120 mL after 12 h, then 240 mL daily) to 54 critically ill patients with an intact gastrointestinal tract. To evaluate kefir’s safety, we monitored for gastrointestinal symptoms. Feasibility was determined by whether patients received a minimum of 75% of their assigned kefir doses. To assess changes in the gut microbiome composition following kefir administration, we collected two stool samples from 13 patients: one within 72 h of admission to the ICU and another at least 72 h after the first stool sample. Results After administering kefir, none of the 54 critically ill patients exhibited signs of kefir-related bacteremia. No side effects like bloating, vomiting, or aspiration were noted, except for diarrhea in two patients concurrently on laxatives. Out of the 393 kefir doses prescribed for all participants, 359 (91%) were successfully administered. We were able to collect an initial stool sample from 29 (54%) patients and a follow-up sample from 13 (24%) patients. Analysis of the 26 paired samples revealed no increase in gut microbial α-diversity between the two timepoints. However, there was a significant improvement in the Gut Microbiome Wellness Index (GMWI) by the second timepoint (P = 0.034, one-sided Wilcoxon signed-rank test); this finding supports our hypothesis that kefir administration can improve gut health in critically ill patients. Additionally, the known microbial species in kefir were found to exhibit varying levels of engraftment in patients’ guts. Conclusions Providing kefir to critically ill individuals is safe and feasible. Our findings warrant a larger evaluation of kefir’s safety, tolerability, and impact on gut microbiome dysbiosis in patients admitted to the ICU. Trial registration NCT05416814; trial registered on June 13, 2022.

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Section: Discussionmentioning

confidence: 99%

Safety, feasibility, and impact on the gut microbiome of kefir administration in critically ill adults

Gupta,

Rajendraprasad,

Ozkan

et al. 2024

BMC Med

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“…In an interesting study in hospitalized humans, it was observed that microbiota-derived lantibiotics similar to nisin could reverse resistance in vancomycin-resistant Enterococcus faecium, a leading cause of hospital infection [96]. Consuming live microorganisms such as Lactobacillus lactis, able to produce nisin A, decreased infections and mortality in intensive care units [97,98]. The pore-forming ability of nisin was shown to depend on the lipid microenvironment, with the lipid cardiolipin facilitating pore formation in mitochondria, possibly leading to cell death and applications against cancer; small natural molecules, phloretin and capsaicin, were also found to potentiate the membrane activity of nisin [99].…”

Section: Chemical Structure and Mode Of Action For Ampsmentioning

confidence: 99%

Antimicrobial Peptides and Their Assemblies

Carmona-Ribeiro

2023

Future Pharmacology

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Antibiotic resistance requires alternatives to fight multi-drug resistant strains. Antimicrobial peptides (AMPs) act by disrupting or solubilizing microbial cell walls or membranes in accordance with mechanisms difficult to counteract from the microbe’s point of view. In this review, structure–activity relationships for AMPs and their assemblies are discussed, considering not only their self-assembly but also their interactions with their carriers for optimal delivery or their combinations with other complementary antimicrobials or moieties covalently bound to their chemical structure. The effect of the formulations on AMP activity is also evaluated, revealing a myriad of possibilities. Depending on the interaction forces between the AMP, the carrier, or the elements added to the formulations, AMP activity can be reduced, enhanced, or remain unaffected. Approaches protecting AMPs against proteolysis may also reduce their activity.

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Bringing gut microbiota into the spotlight of clinical research and medical practice

Davoutis,

Gkiafi,

Lykoudis

2024

World J Clin Cases

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Despite the increasing scientific interest and expanding role of gut microbiota (GM) in human health, it is rarely reported in case reports and deployed in clinical practice. Proteins and metabolites produced by microbiota contribute to immune system development, energy homeostasis and digestion. Exo- and endogenous factors can alter its composition. Disturbance of microbiota, also known as dysbiosis, is associated with various pathological conditions. Specific bacterial taxa and related metabolites are involved in disease pathogenesis and therefore can serve as a diagnostic tool. GM could also be a useful prognostic factor by predicting future disease onset and preventing hospital-associated infections. Additionally, it can influence response to treatments, including those for cancers, by altering drug bioavailability. A thorough understanding of its function has permitted significant development in therapeutics, such as probiotics and fecal transplantation. Hence, GM should be considered as a ground-breaking biological parameter, and it is advisable to be investigated and reported in literature in a more consistent and systematic way.

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Study of the gut microbiome as a novel target for prevention of hospital-associated infections in intensive care unit patients

Cited by 3 publications

References 33 publications

Safety, feasibility, and impact on the gut microbiome of kefir administration in critically ill adults

Safety, feasibility, and impact on the gut microbiome of kefir administration in critically ill adults

Antimicrobial Peptides and Their Assemblies

Bringing gut microbiota into the spotlight of clinical research and medical practice

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