Synbiotics modulate gut microbiota and reduce enteritis and ventilator-associated pneumonia in patients with sepsis: a randomized controlled trial

Shimizu, Kentaro; Yamada, Tomoki; Ogura, Hiroshi; Mohri, Tomoyoshi; Kiguchi, Takeyuki; Fujimi, Satoshi; Asahara, Takashi; Yamada, Tomomi; Ojima, Masahiro; Ikeda, Mitsunori

doi:10.1186/s13054-018-2167-x

Cited by 175 publications

(202 citation statements)

References 37 publications

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“…Probiotics, such as Bifidobacterium bifidum , Streptococcus faecalis and Clostridium butyricum are now available for clinical use, and it is worth considering the use of these probiotics during HSCT. Indeed, a recent report has shown the efficacy of synbiotics containing strains of Bifidobacterium breve and Lactobacillus casei in preventing the incidence of enteritis and pneumonia in patients with septicaemia (Shimizu et al , ). On the other hand, Suez et al () reported that taking probiotics hindered microbiota recovery after antibiotic treatment.…”

Section: Discussionmentioning

confidence: 99%

Pre‐ and post‐serial metagenomic analysis of gut microbiota as a prognostic factor in patients undergoing haematopoietic stem cell transplantation

et al. 2019

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The human gut harbours diverse microorganisms, and gut dysbiosis has recently attracted attention because of its possible involvement in various diseases. In particular, the lack of diversity in the gut microbiota has been associated with complications of haematopoietic stem cell transplantation (HSCT), such as infections, acute graft-versus-host disease and relapse of primary disease, which lead to a poor prognosis. However, few studies have serially examined the composition of the intestinal microbiota after HSCT.In this study, we demonstrated, using next-generation sequencing of the bacterial 16S ribosomal RNA gene, combined with uniFrac distance analysis, that the intestinal microbiota of patients undergoing allogeneic HSCT substantially differed from that of healthy controls and recipients of autologous transplants. Faecal samples were obtained daily throughout the clinical course, before and after transplantation. Notably, the proportions of Bifidobacterium and genera categorized as butyrate-producing bacteria were significantly lower in patients with allogeneic HSCT than in healthy controls. Furthermore, among allogeneic transplant recipients, a subgroup with a preserved microbiota composition showed a benign course, whereas patients with a skewed microbiota showed a high frequency of complications and mortality after transplantation. Thus, we conclude that the stability of intestinal microbiota is critically involved in outcomes of HSCT.

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Section: Discussionmentioning

confidence: 99%

Pre‐ and post‐serial metagenomic analysis of gut microbiota as a prognostic factor in patients undergoing haematopoietic stem cell transplantation

et al. 2019

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“…Shimizu et al [96] have also investigated the ability of a synbiotic (Bifidobacterium breve strain Yakult, Lactobacillus casei strain Shirota, and galactooligosaccharides) to reduce complications in VAP and modulate the gut microbiome, confirming a positive effect.…”

Section: Use Of Probiotics In Ventilator-associated Pneumonia (Vap)mentioning

confidence: 98%

“…The use of prebiotics in combination with probiotics, i.e., synbiotics, is limited in critically ill patients, with few published studies [92][93][94][95][96]. A meta-analysis conducted by Manzanares et al [97] analyzed the therapeutic efficacy of four trials with synbiotics versus 10 trials using probiotics, and found no additional benefit of the synbiotics compared to the probiotics alone.…”

Section: Use Of Prebiotics In Critically Ill Patientsmentioning

confidence: 99%

The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition

et al. 2019

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Critically ill patients have an alteration in the microbiome in which it becomes a disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the Proteobacteria phylum. Although these alterations are multicausal, many of the treatments administered to these patients, like antibiotics, play a significant role. Critically ill patients also have a hyperpermeable gut barrier and dysregulation of the inflammatory response that favor the development of the pathobiome, translocation of pathogens, and facilitate the emergence of sepsis. In order to restore the homeostasis of the microbiome, several nutritional strategies have been evaluated with the aim to improve the management of critically ill patients. Importantly, enteral nutrition has proven to be more efficient in promoting the homeostasis of the gut microbiome compared to parenteral nutrition. Several nutritional therapies, including prebiotics, probiotics, synbiotics, and fecal microbiota transplantation, are currently being used, showing variable results, possibly due to the unevenness of clinical trial conditions and the fact that the beneficial effects of probiotics are specific to particular species or even strains. Thus, it is of great importance to better understand the mechanisms by which nutrition and supplement therapies can heal the microbiome in critically ill patients in order to finally implement them in clinical practice with optimal safety and efficacy.

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“…the decontamination of the digestive tract (SDD), administration of probiotics and prebiotics alone or in combination (synbiotics), and fecal microbiota transplantation (FMT). 3,16,17 The present study aims to describe the IM profiles in critically ill ICU patients, with and without sepsis, and try to shed light on the role of IM as contributing factor in the evolution of these patients and its influence on ICU stay time, development of different medical complications, and mortality. Additionally, we explored several variables recorded upon ICU admission and stay to determine IM covariates and potential confounding variables in this cohort.…”

Section: Introductionmentioning

confidence: 99%

Gut microbiota profiles in critically ill patients, potential biomarkers and risk variables for sepsis

et al. 2020

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Critically ill patients are physiologically unstable and recent studies indicate that the intestinal microbiota could be involved in the health decline of such patients during ICU stays. This study aims to assess the intestinal microbiota in critically ill patients with and without sepsis and to determine its impact on outcome variables, such as medical complications, ICU stay time, and mortality. A multi-center study was conducted with a total of 250 peri-rectal swabs obtained from 155 patients upon admission and during ICU stays. Intestinal microbiota was assessed by sequencing the V3-V4 hypervariable regions of the 16S rRNA gene. Linear mixed models were used to integrate microbiota data with more than 40 clinical and demographic variables to detect covariates and minimize the effect of confounding factors. We found that the microbiota of ICU patients with sepsis has an increased abundance of microbes tightly associated with inflammation, such as Parabacteroides, Fusobacterium and Bilophila species. Female sex and aging would represent an increased risk for sepsis possibly because of some of their microbiota features. We also evidenced a remarkable loss of microbial diversity, during the ICU stay. Concomitantly, we detected that the abundance of pathogenic species, such as Enterococcus spp., was differentially increased in sepsis patients who died, indicating these species as potential biomarkers for monitoring during ICU stay. We concluded that particular intestinal microbiota signatures could predict sepsis development in ICU patients. We propose potential biomarkers for evaluation in the clinical management of ICU patients.

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Synbiotics modulate gut microbiota and reduce enteritis and ventilator-associated pneumonia in patients with sepsis: a randomized controlled trial

Cited by 175 publications

References 37 publications

Pre‐ and post‐serial metagenomic analysis of gut microbiota as a prognostic factor in patients undergoing haematopoietic stem cell transplantation

Pre‐ and post‐serial metagenomic analysis of gut microbiota as a prognostic factor in patients undergoing haematopoietic stem cell transplantation

The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition

Gut microbiota profiles in critically ill patients, potential biomarkers and risk variables for sepsis

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