Role of gut microbiota and bacterial translocation in acute intestinal injury and mortality in patients admitted in ICU for septic shock.

Front Cell Infect Microbiol

Bacterial Virulence and Chronic Infection (VBIC), INSERM U1047, Univ Montpellier, Department of Microbiology and Hospital Hygiene, Platform MICRO&BIO, University Hospital Center (CHU) Nîmes, Nîmes, France.

Published: January 2024

AI Article Synopsis

  • Sepsis is a severe condition that leads to organ dysfunction and death; this study investigates how gut microbiota changes in septic shock patients over a week and its connection to bacterial translocation.
  • Sixty patients in ICU were monitored for changes in gut bacteria diversity, with a focus on those excluded for various gastrointestinal issues or recent treatments.
  • Results showed a significant decrease in gut bacterial diversity by Day 7, notably an increase in Enterococcus and a decrease in other beneficial bacteria, indicating potential implications for treatment and recovery in septic shock patients.

Article Abstract

Introduction: Sepsis is a life-threatening organ dysfunction with high mortality rate. The gut origin hypothesis of multiple organ dysfunction syndrome relates to loss of gut barrier function and the ensuing bacterial translocation. The aim of this study was to describe the evolution of gut microbiota in a cohort of septic shock patients over seven days and the potential link between gut microbiota and bacterial translocation.

Methods: Sixty consecutive adult patients hospitalized for septic shock in intensive care units (ICU) were prospectively enrolled. Non-inclusion criteria included patients with recent or scheduled digestive surgery, having taken laxatives, pre- or probiotic in the previous seven days, a progressive digestive neoplasia, digestive lymphoma, chronic inflammatory bowel disease, moribund patient, and pregnant and lactating patients. The primary objective was to evaluate the evolution of bacterial diversity and richness of gut microbiota during seven days in septic shock. Epidemiological, clinical and biological data were gathered over seven days. Gut microbiota was analyzed through a metagenomic approach. 100 healthy controls were selected among healthy blood donors for reference basal 16S rDNA values.

Results: Significantly lower bacterial diversity and richness was observed in gut microbiota of patients at Day 7 compared with Day 0 (p<0.01). SOFA score at Day 0, Acute Gastrointestinal Injury (AGI) local grade, septic shock origin and bacterial translocation had an impact on alpha diversity. A large increase in Enterococcus genus was observed at Day 7 with a decrease in Enterobacterales, Clostridiales, Bifidobacterium and other butyrate-producing bacteria.

Discussion: This study shows the importance of bacterial translocation during AGI in septic shock patients. This bacterial translocation decreases during hospitalization in ICUs in parallel to the decrease of microbiota diversity. This work highlights the role of gut microbiota and bacterial translocation during septic shock.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765587PMC
http://dx.doi.org/10.3389/fcimb.2023.1330900DOI Listing

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