Gut microbiota in burned patients with Clostridioides difficile infection

Shoaei, Parisa; Shojaei, Hasan; Siadat, Seyed Davar; Moshiri, Arfa; Vakili, Bahareh; Yadegari, Sima; Ataei, Behrooz; Khorvash, Farzin

doi:10.1016/j.burns.2021.11.023

Cited by 9 publications

(8 citation statements)

References 36 publications

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“…Some studies show that CDI patients and mouse model have a low abundance of A. muciniphila ( Rodriguez et al, 2016 ; Deng et al, 2018 ; Pellissery et al, 2021 ), while an increased number of A. muciniphila was observed in other studies ( Sangster et al, 2016 ; Vakili et al, 2020 ; Shoaei et al, 2021 ). This contradictory conclusion associates to various factors.…”

Section: Discussionmentioning

confidence: 93%

Akkermansia muciniphila Ameliorates Clostridioides difficile Infection in Mice by Modulating the Intestinal Microbiome and Metabolites

et al. 2022

Front. Microbiol.

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Clostridioides difficile is a common cause of nosocomial infection. Antibiotic-induced dysbiosis in the intestinal microbiota is a core cause of C. difficile infection (CDI). Akkermansia muciniphila plays an active role in maintaining gastrointestinal balance and might offer the protective effects on CDI as probiotics. Here, we investigated the effects and mechanisms of A. muciniphila on CDI. C57BL/6 mice (n = 29) were administered A. muciniphila MucT (3 × 109 CFUs, 0.2 mL) or phosphate-buffered saline (PBS) by oral gavage for 2 weeks. Mice were pretreated with an antibiotic cocktail and subsequently challenged with the C. difficile strain VPI 10463. A. muciniphila treatment prevented weight loss in mice and reduced the histological injury of the colon. And it also alleviated inflammation and improved the barrier function of the intestine. The administration effects of A. muciniphila may be associated with an increase in short-chain fatty acid production and the maintenance of bile acids’ steady-state. Our results provide evidence that administration of A. muciniphila to CDI mice, with an imbalance in the microbial community structure, lead to a decrease in abundance of members of the Enterobacteriaceae and Enterococcaceae. In short, A. muciniphila shows a potential anti-CDI role by modulating gut microbiota and the metabolome.

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Section: Discussionmentioning

confidence: 93%

Akkermansia muciniphila Ameliorates Clostridioides difficile Infection in Mice by Modulating the Intestinal Microbiome and Metabolites

et al. 2022

Front. Microbiol.

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“…Shoaei et al specifically have performed phenotypic characterization coupled with molecular typing of Clostridium difficile isolates in burned patients with diarrhea, as well as their environmental context. In particular, from the point of view of HCWs-related Clostridium difficile analyses, they collected 29 swabs from HCWs dominant hands which showed positive results for Clostridium difficile colonization in 8 samples, one of which resulted colonized by a toxigenic Clostridium difficile strain ( 51 ). A similar result was highlighted by Segal et al They identified in an anaesthesiologist the source of contamination of post-operative infections of seven ICU patients, detecting in both patients and the anaesthesiologist the same bacteria.…”

Section: Resultsmentioning

confidence: 99%

“…In addition to HCW and patient microbiota analyses, Shoaei et al performed characterization of environment microbiota in rooms of burned patients after Clostridium difficile diagnosis. Of 21 bed sheets collected samples, three resulted colonized by non-toxigenic Clostridium difficile strains, therefore also in this case a correlation between environmental contamination and HAIs, such as CDI, was highlighted (51). Considering environmental contamination and VRE colonization, Freedberg et al tried to define if there might be worse ICU rooms.…”

Section: Healthcare Environment Microbiota and Haismentioning

confidence: 99%

Human microbiome and microbiota identification for preventing and controlling healthcare-associated infections: A systematic review

Tozzo

Delicati

Caenazzo

2022

Front. Public Health

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ObjectiveThis systematic review describes the role of the human microbiome and microbiota in healthcare-associated infections (HAIs). Studies on the microbiota of patients, healthcare environment (HE), medical equipment, or healthcare workers (HCW) and how it could be transmitted among the different subjects will be described in order to define alarming risk factors for HAIs spreading and to identify strategies for HAIs control or prevention.MethodsThis review was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After retrieval in databases, identification, and screening of available records, 36 published studies were considered eligible and included in the review.ResultsA multifaceted approach is required and the analyses of the many factors related to human microbiota, which can influence HAIs onset, could be of paramount importance in their prevention and control. In this review, we will focus mainly on the localization, transmission, and prevention of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) bacteria and Clostridium difficile which are the most common pathogens causing HAIs.ConclusionsHealthcare workers' microbiota, patient's microbiota, environmental and medical equipment microbiota, ecosystem characteristics, ways of transmission, cleaning strategies, and the microbial resistome should be taken into account for future studies on more effective preventive and therapeutic strategies against HAIs.

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“…Previous study has shown that a decrease in SCFA levels is related to susceptibility to inflammation in severe burn patients [ 54 ]. In addition, the long-term and high-dose use of antibiotics will also aggravate the imbalance of intestinal flora and may increase the risk of Clostridium difficile infection [ 55 ]. Although there was no positive detection of Clostridium difficile , at least in the blood samples in our data (Additional file 2 : Table S4), we indeed found that a large portion of patients had an imbalance in the faecal Coccus -to- Bacillus (C/B) ratio, which may be attributed to Clostridium difficile .…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China

Qin

et al. 2022

Military Med Res

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Background Data on severe and extensive burns in China are limited, as is data on the prevalence of a range of related gastrointestinal (GI) disorders [such as stress ulcers, delayed defecation, opioid-related bowel immotility, and abdominal compartment syndrome (ACS)]. We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality. Methods This retrospective analysis was conducted on patients with severe [≥ 20% total burn surface area (TBSA)] and extensive (> 50% TBSA or > 25% full-thickness TBSA) burns admitted to three university teaching institutions in China between January 1, 2011 and December 31, 2020. Both 30- and 90-day mortality were assessed by collating demographic data, burn causes, admission TBSA, % full-thickness TBSA, Baux score, Abbreviated Burn Severity Index (ABSI) score, and Sequential Organ Failure Assessment (SOFA) score, shock at admission and the presence of an inhalation injury. GI dysfunction included abdominal distension, nausea/vomiting, diarrhoea/constipation, GI ulcer/haemorrhage, paralytic ileus, feeding intolerance and ACS. Surgeries, length of intensive care unit (ICU) stay, pain control [in morphine milligram equivalents (MME)] and overall length of hospital stay (LOHS) were recorded. Results We analyzed 328 patients [75.6% male, mean age: (41.6 ± 13.6) years] with a median TBSA of 62.0% (41.0–80.0%); 256 (78.0%) patients presented with extensive burns. The 90-day mortality was 23.2% (76/328), with 64 (84.2%) of these deaths occurring within 30 d and 25 (32.9%) occurring within 7 d. GI dysfunction was experienced by 45.4% of patients and had a significant effect on 90-day mortality [odds ratio (OR) = 14.070, 95% confidence interval (CI) 5.886–38.290, P < 0.001]. Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and % full-thickness TBSA. Overall, 88.2% (67/76) of deceased patients had GI dysfunction [hazard ratio (HR) for death of GI dysfunction = 5.951], with a survival advantage for functional disorders (diarrhoea, constipation, or nausea/vomiting) over GI ulcer/haemorrhage (P < 0.001). Conclusion Patients with severe burns have an unfavourable prognosis, as nearly one-fifth died within 90 d. Half of our patients had comorbidities related to GI dysfunction, among which GI ulcers and haemorrhages were independently correlated with 90-day mortality. More attention should be given to severe burn patients with GI dysfunction.

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Gut microbiota in burned patients with Clostridioides difficile infection

Cited by 9 publications

References 36 publications

Akkermansia muciniphila Ameliorates Clostridioides difficile Infection in Mice by Modulating the Intestinal Microbiome and Metabolites

Akkermansia muciniphila Ameliorates Clostridioides difficile Infection in Mice by Modulating the Intestinal Microbiome and Metabolites

Human microbiome and microbiota identification for preventing and controlling healthcare-associated infections: A systematic review

Gastrointestinal dysfunction is associated with mortality in severe burn patients: a 10-year retrospective observational study from South China

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