دورية أكاديمية
Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.
| العنوان: | Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study. |
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| المؤلفون: | Lamarche D; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada., Johnstone J; Department of Medicine, University of Toronto, Toronto, ON, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.; Public Health Ontario, Toronto, ON, Canada., Zytaruk N; St. Joseph's Healthcare, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada., Clarke F; St. Joseph's Healthcare, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada., Hand L; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.; Hamilton Health Sciences, Hamilton, ON, Canada., Loukov D; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Department of Pathology and Molecular Medicine, Hamilton, ON, Canada., Szamosi JC; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada., Rossi L; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada., Schenck LP; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada., Verschoor CP; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada., McDonald E; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada., Meade MO; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.; Hamilton Health Sciences, Hamilton, ON, Canada.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada., Marshall JC; Department of Surgery, University of Toronto, Toronto, ON, Canada.; Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada., Bowdish DME; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.; Department of Pathology and Molecular Medicine, Hamilton, ON, Canada., Karachi T; Hamilton Health Sciences, Hamilton, ON, Canada.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada., Heels-Ansdell D; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada., Cook DJ; St. Joseph's Healthcare, Hamilton, ON, Canada.; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada., Surette MG; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada. Surette@mcmaster.ca.; Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada. Surette@mcmaster.ca.; Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Surette@mcmaster.ca.; Department of Medicine, McMaster University, Health Sciences Bldg, 3N8F, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. Surette@mcmaster.ca. |
| مؤلفون مشاركون: | PROSPECT Investigators, Canadian Critical Care Trials Group, Canadian Critical Care Translational Biology Group |
| المصدر: | Respiratory research [Respir Res] 2018 Dec 07; Vol. 19 (1), pp. 245. Date of Electronic Publication: 2018 Dec 07. |
| نوع المنشور: | Journal Article; Observational Study; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2001- : London : BioMed Central Ltd. Original Publication: London : Current Science Ltd., c2000- |
| مواضيع طبية MeSH: | Microbiological Phenomena*, Dysbiosis/*microbiology , Dysbiosis/*mortality , Respiration, Artificial/*adverse effects , Respiration, Artificial/*mortality, Aged ; Critical Illness/epidemiology ; Critical Illness/therapy ; Dysbiosis/etiology ; Female ; Humans ; Intensive Care Units/trends ; Male ; Middle Aged ; Pilot Projects ; Prospective Studies |
| مستخلص: | Background: Host-associated microbial communities have important roles in tissue homeostasis and overall health. Severe perturbations can occur within these microbial communities during critical illness due to underlying diseases and clinical interventions, potentially influencing patient outcomes. We sought to profile the microbial composition of critically ill mechanically ventilated patients, and to determine whether microbial diversity is associated with illness severity and mortality. Methods: We conducted a prospective, observational study of mechanically ventilated critically ill patients with a high incidence of pneumonia in 2 intensive care units (ICUs) in Hamilton, Canada, nested within a randomized trial for the prevention of healthcare-associated infections. The microbial profiles of specimens from 3 anatomical sites (respiratory, and upper and lower gastrointestinal tracts) were characterized using 16S ribosomal RNA gene sequencing. Results: We collected 65 specimens from 34 ICU patients enrolled in the trial (29 endotracheal aspirates, 26 gastric aspirates and 10 stool specimens). Specimens were collected at a median time of 3 days (lower respiratory tract and gastric aspirates; interquartile range [IQR] 2-4) and 6 days (stool; IQR 4.25-6.75) following ICU admission. We observed a loss of biogeographical distinction between the lower respiratory tract and gastrointestinal tract microbiota during critical illness. Moreover, microbial diversity in the respiratory tract was inversely correlated with APACHE II score (r = - 0.46, p = 0.013) and was associated with hospital mortality (Median Shannon index: Discharged alive; 1.964 vs. Deceased; 1.348, p = 0.045). Conclusions: The composition of the host-associated microbial communities is severely perturbed during critical illness. Reduced microbial diversity reflects high illness severity and is associated with mortality. Microbial diversity may be a biomarker of prognostic value in mechanically ventilated patients. Trial Registration: ClinicalTrials.gov ID NCT01782755 . Registered February 4 2013. |
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| فهرسة مساهمة: | Keywords: Critical illness; Gastrointestinal tract microbiota; Microbial diversity; Microbiome; Respiratory tract microbiota |
| سلسلة جزيئية: | ClinicalTrials.gov NCT01782755 |
| تواريخ الأحداث: | Date Created: 20181212 Date Completed: 20190101 Latest Revision: 20190101 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC6286574 |
| DOI: | 10.1186/s12931-018-0950-5 |
| PMID: | 30526610 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1465-993X |
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| DOI: | 10.1186/s12931-018-0950-5 |