Gut Microbiota Composition Can Predict Colonization by Multidrug-Resistant Bacteria in SARS-CoV-2 Patients in Intensive Care Unit: A Pilot Study

Abstract

The SARS-CoV-2 infection has increased the number of patients entering Intensive Care Unit (ICU) facilities and antibiotic treatments. Concurrently, the multi-drug resistant bacteria (MDRB) colonization index has risen. Considering that most of these bacteria are derived from gut microbiota, the study of its composition is essential. Additionally, SARS-CoV-2 infection may promote gut dysbiosis, suggesting an effect on microbiota composition. This pilot study aims to determine bacteria biomarkers to predict MDRB colonization risk in SARS-CoV-2 patients in ICUs. Seventeen adult patients with an ICU stay >48 h and who tested positive for SARS-CoV-2 infection were enrolled in this study. Patients were assigned to two groups according to routine MDRB colonization surveillance: non-colonized and colonized. Stool samples were collected when entering ICUs, and microbiota composition was determined through Next Generation Sequencing techniques. Gut microbiota from colonized patients presented significantly lower bacterial diversity compared with non-colonized patients (p < 0.05). Microbiota in colonized subjects showed higher abundance of Anaerococcus, Dialister and Peptoniphilus, while higher levels of Enterococcus, Ochrobactrum and Staphylococcus were found in non-colonized ones. Moreover, LEfSe analysis suggests an initial detection of Dialister propionicifaciens as a biomarker of MDRB colonization risk. This pilot study shows that gut microbiota profile can become a predictor biomarker for MDRB colonization in SARS-CoV-2 patients.

ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review

“…However, whether the alteration of microbiota results in different effects on ICU-acquired infection in COVID-19 patients, as compared with non-COVID-19 patients is still to be evaluated. In a recent pilot study performed in 17 COVID-19 patients, gut microbiota composition significantly differed between patients with ICU-acquired colonization related to MDR bacteria, compared with those with no MDR bacteria colonization [ 59 ]. Further studies are needed to confirm these findings.…”

Prevalence and Impact on Mortality of Colonization and Super-Infection by Carbapenem-Resistant Gram-Negative Organisms in COVID-19 Hospitalized Patients

“…Of particular note, the rise in multidrug-resistant bacterial intestinal carriage drives superinfections and mortality [ 8 , 9 ], which are particularly worrisome in vulnerable populations. Recently, a Spanish pilot study showed that the gut microbiota profile can become a predictive biomarker for multidrug-resistant bacteria colonization in SARS-CoV-2 patients [ 10 ]. Among Gram-negative bacteria, Acinetobacter baumannii and Klebsiella pneumoniae have been reported as the most frequently isolated species among COVID-19 patients with hospital-acquired superinfections [ 5 , 6 ].…”

The Impact of Acinetobacter baumannii Infections in COVID-19 Patients Admitted in Hospital Intensive Care Units

“…Since the close of 2019, the pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has significantly strained healthcare systems worldwide, primarily attributed to the substantial number of infected individuals necessitating extended hospital stays and intensive care [7]. A recent pilot study conducted in Spain highlighted the potential of gut microbiota profiling as a predictive biomarker for colonizing MDR bacteria in patients with SARS-CoV-2 infection [8]. Among GNB, A. baumannii and Klebsiella pneumoniae have emerged as the most commonly isolated species in COVID-19 patients who experience hospital-acquired superinfections [9].…”