Altered gut flora are associated with septic complications and death in critically ill patients with systemic inflammatory response syndrome
Open accessAbstract
BACKGROUND: Gut under severe insult is considered to have an important role in promoting infection and multiple organ dysfunction syndrome from the viewpoint of altered intestinal epithelium, immune system and commensal bacteria. There are few reports, however, about the relationship between gut flora and septic complications. METHODS: We analyzed gut flora in patients with systemic inflammatory response syndrome (SIRS) and evaluated key bacteria and their cutoff values for infectious complications and mortality by using classification and regression trees (CART). Eighty-one SIRS patients with a serum C-reactive protein level higher than 10 mg/dL treated in the intensive care unit (ICU) for more than 2 days were included for the study. We quantitatively evaluated nine types of bacteria in fecal samples by plate or tube technique. Two hundred seventy-one samples were analyzed using CART and logistic regression. RESULTS: The dominant factors for complication of enteritis were the minimum number of total obligate anaerobes and the maximum number of Staphylococcus and Enterococcus. The dominant factors for complication of bacteremia were the minimum numbers of total obligate anaerobes and total facultative anaerobes. The dominant factors for mortality were the numbers of total obligate anaerobes and total facultative anaerobes and age. CONCLUSIONS: A decrease in total obligate anaerobes and an increase in pathogenic bacteria in the gut are associated with septic complications and mortality in patients with SIRS. The altered gut flora may be a potential prognostic marker in SIRS patients.
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The lower gastrointestinal tract in critical illness loses diversity and the community is overrun by a few bacterial species.
“The lower gastrointestinal tract, which in healthy people contains hundreds of distinct bacterial species, loses diversity, and the community is overrun by a few (in some cases only one) bacterial species.”
From The microbiome and critical illness (2016) · cites this paper as [69]
Dominant species in the lower gastrointestinal tract of critically ill patients include S aureus, Enterococcus spp, and members of the Enterobacteriaceae family.
“Dominant species include S aureus, Enterococcus spp, and members of the Enterobacteriaceae family (including E coli and Klebsiella spp).”
From The microbiome and critical illness (2016) · cites this paper as [69]
In studies of the gut microbiome in critically ill patients, butyrate-producing bacteria are uncommon or absent, and butyrate production is at a minimum.
“In studies of the gut microbiome in critically ill patients, butyrate-producing bacteria are uncommon or absent,20,69–71 and butyrate production is at a minimum.”
From The microbiome and critical illness (2016) · cites this paper as [69]
P aeruginosa, which is normally low in abundance, grows in prominence in the gut of critically ill patients.
“P aeruginosa, which is normally low in abundance, grows in prominence.”
From The microbiome and critical illness (2016) · cites this paper as [69]
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References 30 · Cited by 213
Research works printed but not linked: 1
- [15]Azuma R Suto T Izuka H Hasegawa T Validity of transfer of the taxonomical position of Corynebacterium pseudopyogenes from genus Corynebacterium to genus Actinomyces Proceeding of the First International Conference on Culture Collection 1970 Tokyo University of Tokyo Press 493 505
- Authors
- Shimizu, K., Ogura, H., Hamasaki, T., Goto, M., Tasaki, O., Asahara, T., Nomoto, K., Morotomi, M., Matsushima, A., Kuwagata, Y., & Sugimoto, H.
- Affiliations
- Osaka University Hospital (JP)
- The University of Osaka (JP)
- Yakult Central Institute (JP)
- Chukyo Hospital (JP)
- Hoshigaoka Medical Center (JP)
- Corresponding author
- Shimizu, Kentaro
- ORCID
- Venue
- Digestive Diseases and Sciences
- Published
- 2010-10-08
- Volume
- 56
- Issue
- 4
- Pages
- 1171-1177
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- PMC
- PMC3059822
- OpenAlex
- W2031634435
- Cited by
- 213
- References
- 30
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 17 · 2023: 17 · 2022: 23 · 2021: 22 · 2020: 22 · 2019: 13 · 2018: 8 · 2017: 10 · 2016: 16 · 2015: 13 · 2014: 5 · 2013: 12 · 2012: 8
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Digestive Diseases and Sciences (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- gut microbiota, systemic inflammatory response syndrome, sepsis, critically ill patients, obligate anaerobes, facultative anaerobes, Staphylococcus, Enterococcus, bacteremia, enteritis, mortality, prognostic factors, fecal bacteria, C-reactive protein
- MeSH terms
- Adult, Aged, C-Reactive Protein, Critical Care, Enteritis, Feces, Female, Humans, Male, Middle Aged, Multiple Organ Failure, Prognosis, Staphylococcus, Bacteremia, Critical Illness, Enterococcus, Systemic Inflammatory Response Syndrome, Gastrointestinal Tract
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