Dataset Information

Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.

ABSTRACT:

Background

Host-associated microbial communities have important roles in tissue homeostasis and overall health. Severe perturbations can occur within these microbial communities during critical illness due to underlying diseases and clinical interventions, potentially influencing patient outcomes. We sought to profile the microbial composition of critically ill mechanically ventilated patients, and to determine whether microbial diversity is associated with illness severity and mortality.

Methods

We conducted a prospective, observational study of mechanically ventilated critically ill patients with a high incidence of pneumonia in 2 intensive care units (ICUs) in Hamilton, Canada, nested within a randomized trial for the prevention of healthcare-associated infections. The microbial profiles of specimens from 3 anatomical sites (respiratory, and upper and lower gastrointestinal tracts) were characterized using 16S ribosomal RNA gene sequencing.

Results

We collected 65 specimens from 34 ICU patients enrolled in the trial (29 endotracheal aspirates, 26 gastric aspirates and 10 stool specimens). Specimens were collected at a median time of 3 days (lower respiratory tract and gastric aspirates; interquartile range [IQR] 2-4) and 6 days (stool; IQR 4.25-6.75) following ICU admission. We observed a loss of biogeographical distinction between the lower respiratory tract and gastrointestinal tract microbiota during critical illness. Moreover, microbial diversity in the respiratory tract was inversely correlated with APACHE II score (r = - 0.46, p = 0.013) and was associated with hospital mortality (Median Shannon index: Discharged alive; 1.964 vs. Deceased; 1.348, p = 0.045).

Conclusions

The composition of the host-associated microbial communities is severely perturbed during critical illness. Reduced microbial diversity reflects high illness severity and is associated with mortality. Microbial diversity may be a biomarker of prognostic value in mechanically ventilated patients.

Trial registration

ClinicalTrials.gov ID NCT01782755 . Registered February 4 2013.

SUBMITTER: Lamarche D

PROVIDER: S-EPMC6286574 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.

Lamarche Daphnée D Johnstone Jennie J Zytaruk Nicole N Clarke France F Hand Lori L Loukov Dessi D Szamosi Jake C JC Rossi Laura L Schenck Louis P LP Verschoor Chris P CP McDonald Ellen E Meade Maureen O MO Marshall John C JC Bowdish Dawn M E DME Karachi Tim T Heels-Ansdell Diane D Cook Deborah J DJ Surette Michael G MG

Respiratory research 20181207 1

<h4>Background</h4>Host-associated microbial communities have important roles in tissue homeostasis and overall health. Severe perturbations can occur within these microbial communities during critical illness due to underlying diseases and clinical interventions, potentially influencing patient outcomes. We sought to profile the microbial composition of critically ill mechanically ventilated patients, and to determine whether microbial diversity is associated with illness severity and mortality ...[more]

PMID: 30526610

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Dataset Information

Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.

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