Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion*

Wurm, Philipp; Spindelboeck, Walter; Krause, Robert; Plank, Johannes; Fuchs, G.; Bashir, Mina; Petritsch, Wolfgang; Halwachs, Bettina; Langner, Cord; Högenauer, Christoph; Gorkiewicz, Gregor

doi:10.1097/ccm.0000000000002310

Cited by 45 publications

(27 citation statements)

References 44 publications

(46 reference statements)

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Section: Resultsmentioning

confidence: 99%

“…The first 2 cases ever reported came from the same group at Nanjing University (Nanjing, China) in 2014 and 2015 . Two subsequent cases were reported by a group at Daping Hospital (Chongqing, China) in 2016, whereas the most recent case was reported by a group at the Medical University of Graz (Graz, Austria) in 2017 . The cases shared common features of high fevers, septic shock, and high‐volume diarrhea in patients with initially negative infectious cultures and no clear explanation for their severe presentation.…”

Section: Resultsmentioning

confidence: 99%

“…After a broad literature search, we found 4 case reports that described the use of FMT in 5 critically ill patients (1 teenager and 4 adults) with persistent SIRS and no clear etiology or source of infection (Table 1). [33][34][35][36] The first 2 cases ever reported came from the same group at Nanjing University (Nanjing, China) in 2014 and 2015. 33,34 Two subsequent cases were reported by a group at Daping Hospital (Chongqing, China) in 2016, 35 whereas the most recent case was reported by a group at the Medical University of Graz (Graz, Austria) in 2017.…”

Section: Resultsmentioning

confidence: 99%

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Fecal Microbiota Transplantation for the Critically Ill Patient

et al. 2018

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The gut microbiome has been implicated in a diversity of diseases, such as irritable bowel syndrome, inflammatory bowel disease, hepatic steatosis, metabolic syndrome, obesity, and anxiety. Current research also suggests the presence of a bidirectional relationship between the composition of the gut microbiome and critical illness. In the critical care setting, multiple factors (eg, use of antibiotics, aberrant nutrition, bloodstream infections, bowel ischemia, and abnormal bowel motility) strongly contribute to intestinal dysbiosis. Conversely, early studies have associated intestinal dysbiosis with worse clinical outcomes in the intensive care unit (ICU), such as infection, organ failure, and mortality. The possibility of intestinal dysbiosis influencing these clinical outcomes has prompted the question of whether microbiome manipulation strategies, such as fecal microbiota transplantation (FMT), may have a role in the management of critical illness. After a literature search of FMT used in the ICU for indications other than Clostridium difficile infections, we found 4 case reports that describe the use of FMT in 5 critically ill patients with systemic inflammatory responses and no clear source of infection. This review discusses the relationship between the gut microbiome and critical illness, early data on the use of FMT in critical care, and safety considerations of FMT in the critically ill and immunocompromised populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Fecal Microbiota Transplantation for the Critically Ill Patient

et al. 2018

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“…In the present study by Wurm, Spindelböck, et al (5) three, relatively young, patients were admitted to intensive care units at Medical University of Graz in Austria for various reasons and symptomatology. During their ICU admission, each patient developed severe, high volume diarrhea.…”

mentioning

confidence: 87%

“…At first glance, the provision of an FMT to the critically ill patients described by Wurm, Spindelböck, et al (5) appears as some form of reckless empiricism. Yet, in the context of the historical perspective, and on compassionate plea for the lives of the patients herein reported, it might have been life-saving.…”

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confidence: 99%

Fecal Micobiota Transplantation to Treat Sepsis of Unclear Etiology*

Gaines

Alverdy²

2017

Critical Care Medicine

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A case of massive refractory diarrhea in a patient with COVID‐19

Shimizu

Hirata

Tokuhira

et al. 2022

Acute Medicine & Surgery

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Background The new coronavirus disease (COVID‐19) causes gastrointestinal symptoms as well as respiratory symptoms. Case Presentation A 60‐year‐old man was transferred with respiratory difficulty. He was diagnosed as having COVID‐19 and was intubated and placed on mechanical ventilation. He suffered from diarrhea from day 12 and produced a maximum of approximately 6,384 mL/day of watery diarrhea on day 21. He required massive transfusion. Adsorbents and pectin‐containing oligomeric formulas were administered, which decreased the amount of diarrhea. Fecal metagenomic analysis showed the proportions of the genera Enterococcus and Staphylococcus were the most dominate at the genus level. The proportion of Bacteroidetes was <1%. Thereafter, his diarrhea decreased to several times, and he was transferred to another ward on day 104. Conclusion Therapy for intestinal complications as well as that for pneumonia might be important in treating COVID‐19.

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Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion*

Abstract: Supplemental Digital Content is available in the text.

Cited by 45 publications

References 44 publications

Fecal Microbiota Transplantation for the Critically Ill Patient

Fecal Microbiota Transplantation for the Critically Ill Patient

Fecal Micobiota Transplantation to Treat Sepsis of Unclear Etiology*

A case of massive refractory diarrhea in a patient with COVID‐19

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