Loss of Health Promoting Bacteria in the Gastrointestinal Microbiome of PICU Infants with Bronchiolitis: A Single-Center Feasibility Study

Abstract

The feasibility of gastrointestinal (GI) microbiome work in a pediatric intensive care unit (PICU) to determine the GI microbiota composition of infants as compared to control infants from the same hospital was investigated. In a single-site observational study at an urban quaternary care children’s hospital in Western Michigan, subjects less than 6 months of age, admitted to the PICU with severe respiratory syncytial virus (RSV) bronchiolitis, were compared to similarly aged control subjects undergoing procedural sedation in the outpatient department. GI microbiome samples were collected at admission (n = 20) and 72 h (n = 19) or at time of sedation (n = 10). GI bacteria were analyzed by sequencing the V4 region of the 16S rRNA gene. Alpha and beta diversity were calculated. Mechanical ventilation was required for the majority (n = 14) of study patients, and antibiotics were given at baseline (n = 8) and 72 h (n = 9). Control subjects’ bacterial communities contained more Porphyromonas, and Prevotella (p = 0.004) than those of PICU infants. The ratio of Prevotella to Bacteroides was greater in the control than the RSV infants (mean ± SD—1.27 ± 0.85 vs. 0.61 ± 0.75: p = 0.03). Bacterial communities of PICU infants were less diverse than those of controls with a loss of potentially protective populations.

To kill or to be killed: pangenome analysis of Escherichia coli strains reveals a tailocin specific for pandemic ST131

“…Several studies have shown that, in critically ill patients, dysbiosis (disruption of the microbiota homeostasis due to an imbalance in the microflora) involves the loss of health benefits from disappearing commensal bacteria and the overgrowth by pathogenic strains [150][151][152][153][154]. Pathogenic E. coli can cause diarrhea and has also been observed in critically ill patients requiring ICU support [155,156].…”

Respiratory and Gut Microbiome Modification during Respiratory Syncytial Virus Infection: A Systematic Review

“…Of the remaining 225 articles, the number of ineligible articles after the review of titles and abstracts was 189. A full-text review was performed for 36 articles, and 12 articles (respiratory tract microbiome: 9; gut microbiome: 2; both: 1) met the inclusion criteria and were included in this review [ 26 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. A full list of reasons for exclusion is shown in Figure 1 .…”

“…The characteristics of the included studies are shown in Table 1 (respiratory tract microbiome compared to healthy controls), Table 2 (gut microbiome), and Table S2 (respiratory tract microbiome compared to patients other than healthy controls). All of the studies were conducted in industrialized countries: the United States of America ( n = 8) [ 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], Spain ( n = 1) [ 29 ], Italy ( n = 1) [ 39 ], the Netherlands ( n = 1) [ 31 ], and China ( n = 1) [ 26 ]. Although five of the studies included in this review were multicenter studies, no studies were conducted in multiple countries [ 31 , 32 , 34 , 35 , 37 ].…”

“…All of the studies recruited children under 3 years of age. The microbiome community in patients with RSV infection was compared to healthy controls in 8 out of the 12 studies including both the respiratory tract and gut microbiome [ 29 , 30 , 31 , 32 , 33 , 36 , 38 , 39 ]. Three studies focused on the presence or absence of recurrent wheezing later in life [ 26 , 35 , 37 ].…”

“…One study compared RSV infection alone, RSV/human rhino virus (HRV) co-infection, and HRV infection alone [ 34 ]. RSV infection was diagnosed via polymerase chain reaction (PCR) in all 12 studies [ 26 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], and direct immunofluorescence antibody [ 29 ] and rapid antigen tests [ 30 ] were also used to confirm RSV infection.…”