Impact of microbiome-based interventions on gastrointestinal pathogen colonization in the intensive care unit

Choy, Alexa; Freedberg, Daniel E.

doi:10.1177/1756284820939447

Cited by 11 publications

(10 citation statements)

References 131 publications

(183 reference statements)

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“…Nevertheless, there is, at least in part, a correlation of coexisting oral dysbiosis and gut abnormalities with the disease course and prognosis of COVID-19 patients receiving ECMO. The initial identification of COVID patients, with the coexistence of oral dysbiosis and gut abnormalities, could help to predict the outcomes of severe COVID patients and could lead to the development of more effective treatments that combine routine oral hygiene intervention and symbiotic therapy [ 29 , 30 ]. Therefore, a multidisciplinary approach should be strongly promoted by emergency physicians, as well as gastroenterologists, oral healthcare specialists, and nurses integrated into ICU teams.…”

Section: Discussionmentioning

confidence: 99%

The Association between the Oral-Gut Axis and the Outcomes of Severe COVID-19 Patients Receiving Extracorporeal Membrane Oxygenation: A Case-Control Study

Yoshino

Nakamura

Hashiguchi

et al. 2022

JCM

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The novel conceptual disease model, the oral–gut axis, which represents the immunomodulatory mutual relationship between oral and gut microbial compartments, has been attracting attention in relation to systemic health issues. We investigated whether this unique crosstalk influences the systemic condition of patients with COVID-19 infections who received extracorporeal membrane oxygenation (ECMO) in the intensive care unit (ICU) during April and December 2020. In this case-control study, patients were divided into two groups according to their survival (total entry size, n = 21; survivors, n = 13; non-survivors, n = 8). Patients were evaluated using the oral assessment guide from Fukuoka University (OAG-F) and the Bristol Stool Form Scale (BSFS) to examine the oral and fecal conditions. A blood-based inflammatory factor, the neutrophil-to-lymphocyte ratio (NLR), was used as an indicator of systemic immunity. The high total OAG-F scores were associated with both elevated BSFS and NLR values, and a mutually positive correlation between BSFS and NLR was observed. This indicated an interplay between oral deterioration, gut dysbiosis, and the impairment of immunity. Furthermore, oral deterioration was more frequently observed in non-survivors on day 14 of ICU admission. In addition, on days 7 and 21 of ICU admission, impaired immunity, reflected by an elevated NLR, was observed in non-survivors. However, the distribution of the gut microbiome—reflected by increased BSFS values—with the time it was examined was not directly observed in non-survivors. Taken together, these findings suggested that oral–gut health may be specifically associated with mortality in COVID-19 patients receiving ECMO in the ICU.

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Section: Discussionmentioning

confidence: 99%

The Association between the Oral-Gut Axis and the Outcomes of Severe COVID-19 Patients Receiving Extracorporeal Membrane Oxygenation: A Case-Control Study

Yoshino

Nakamura

Hashiguchi

et al. 2022

JCM

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“…The action of selective gut decontamination actually facilitates 'rebound colonization' with potentially pathogenic organisms, non normal microflora, after surgery procedure [95]. Rebound colonization can possibly took place with dangerous nosocomial aerobic pathogen [96].…”

Section: Antibioticsmentioning

confidence: 99%

Microbial Normal Flora: Its Existence And Their Contribution To Homeostasis

Sunarti

2022

JAMB

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Aims: To describe the existence of microbial normal flora and its contribution to homeostasis, with emphasize on several major systems of the human body. Discussion: Normal microflora are a group of various microorganisms that reside in the bodies of all humans or animals. These organisms are consistently exist, and relatively stable, with specific genera populating various body regions during particular periods in an individual's life, from shortly after birth until death. The indigeneous normal microbiota provides a first line of defense against microbial pathogens, assists in digestion, and contributes to maturation of the immune system and in general able to assists the anatomy, physiology, susceptibility to pathogens, and even morbidity of the host. Several internal factors like age and external factors like geographical position, diets habbits, the condition of stress, infection and even antibiotics consumption, are some factors that can affect the function of normal microflora. Conclusion: Normal microbial microflora consistently inhabits some region of the body and influences the hots’s homeostasis. Several factors such as diets, stress, infection and antibiotics administration, can affect the existence and performance of normal microflora.

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“…Indeed, the use of these compounds can determine the proliferation of pathogenic bacteria vs. commensal-ones [19]. In addition, broad-spectrum antibiotic use can allow the proliferation of resistant bacteria of new-origin or already present in the gut [20]. Furthermore, there is an increased dissemination of these bacteria into the ICU environment via contact with healthcare workers, adjacent patients or contaminated objects [21].…”

Section: Gut Microbiota Composition In Health and Critically Ill Patientmentioning

confidence: 99%

“…Furthermore, there is an increased dissemination of these bacteria into the ICU environment via contact with healthcare workers, adjacent patients or contaminated objects [21]. Other operations typical of ICU patients, potentially responsible for gut dysbiosis, are proton pump inhibitors usage and enteral feeding or delayed enteral feeding [20].…”

Section: Gut Microbiota Composition In Health and Critically Ill Patientmentioning

confidence: 99%

“…Probiotics are live, ingestible microorganisms beneficially affecting host health [34]. Probiotics can be able to prevent gut microbiota colonization by multi (or not)-drugresistant pathogens through: competition, modulation of gut pH, enhancement of innate and adaptive immunity and direct production of antimicrobial substances [20,35]. There are solid data from systematic reviews and meta-analyses supporting the beneficial effects of probiotics in critically ill patients [36].…”

Section: Probioticsmentioning

confidence: 99%

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Nutritional Status and the Critically Ill Patient: Gut Microbiota and Immuno-Nutrition in I.C.U. at the Time of SARS-COV 2 Pandemic

Scarpellini¹,

Scarcella

Romanelli³

et al. 2021

Gastroenterology Insights

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Background: Gut microbiota is a complex ecosystem of bacteria, viruses, archaea, protozoa and yeasts in our intestine. It has several functions, including maintaining human body equilibrium. Microbial “dysbiosis” can be responsible for outbreak of local and systemic infections, especially in critically ill patients. Methods: to build a narrative review, we performed a Pubmed, Medline and EMBASE search for English language papers, reviews, meta-analyses, case series and randomized controlled trials (RCTs) by keywords and their associations: critically ill patient; nutrition; gut microbiota; probiotics; gut virome; SARS-COV 2. Results: Over the antibiotic-based “selective decontamination”, potentially responsible for drug-resistant microorganisms development, there is growing interest of scientists and the pharmaceutical industry for pre-, probiotics and their associations as safe and reliable remedies restoring gut microbial “eubiosis”. Very first encouraging evidences link different gut microbiota profiles with SARS-COV 2 disease stage and gravity. Thus, there is frame for a probiotic therapeutic approach of COVID-19. Conclusions: gut microbiota remodulation seems to be a promising and safe therapeutic approach to prevent local and systemic multi-resistant bug infections in the intensive care unit (ICU) patients. This approach deserves more and more attention at the time of SARS-COV 2 pandemic.

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Impact of microbiome-based interventions on gastrointestinal pathogen colonization in the intensive care unit

Cited by 11 publications

References 131 publications

The Association between the Oral-Gut Axis and the Outcomes of Severe COVID-19 Patients Receiving Extracorporeal Membrane Oxygenation: A Case-Control Study

The Association between the Oral-Gut Axis and the Outcomes of Severe COVID-19 Patients Receiving Extracorporeal Membrane Oxygenation: A Case-Control Study

Microbial Normal Flora: Its Existence And Their Contribution To Homeostasis

Nutritional Status and the Critically Ill Patient: Gut Microbiota and Immuno-Nutrition in I.C.U. at the Time of SARS-COV 2 Pandemic

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