Abstract:
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.
journal_name
Respir Resjournal_title
Respiratory researchauthors
Lamarche D,Johnstone J,Zytaruk N,Clarke F,Hand L,Loukov D,Szamosi JC,Rossi L,Schenck LP,Verschoor CP,McDonald E,Meade MO,Marshall JC,Bowdish DME,Karachi T,Heels-Ansdell D,Cook DJ,Surette MG,PROSPECT Investigators.,Cdoi
10.1186/s12931-018-0950-5subject
Has Abstractpub_date
2018-12-07 00:00:00pages
245issue
1eissn
1465-9921issn
1465-993Xpii
10.1186/s12931-018-0950-5journal_volume
19pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Neonatal mice developed neurological disease and pulmonary dysfunction after an infection with a mouse-adapted human Enterovirus 71 (EV71) strain MP4. However, the hallmark of severe human EV71 infection, pulmonary edema (PE), was not evident. METHODS:To test whether EV71-induced PE required a proinflammato...
journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/1465-9921-12-147
更新日期:2011-11-06 00:00:00
abstract:BACKGROUND:It is unclear whether the responses of refractory and common Mycoplasma pneumoniae (MP) pneumonia to macrolides differ. Hence, this study aimed to identify biomarkers that may be used to distinguish refractory and common pneumonias caused by MP in children at hospital admission. METHODS:The study included 1...
journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/s12931-019-1152-5
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journal_title:Respiratory research
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doi:10.1186/1465-9921-10-55
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journal_title:Respiratory research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1465-9921-11-29
更新日期:2010-03-09 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章,评审
doi:10.1186/s12931-017-0526-9
更新日期:2017-02-28 00:00:00
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pub_type: 杂志文章,评审
doi:10.1186/1465-9921-6-78
更新日期:2005-07-21 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/1465-9921-8-18
更新日期:2007-03-06 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/s12931-015-0265-8
更新日期:2015-09-16 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
doi:10.1186/s12931-019-1180-1
更新日期:2019-09-12 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1186/s12931-015-0251-1
更新日期:2015-08-05 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12931-018-0795-y
更新日期:2018-06-06 00:00:00
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pub_type: 杂志文章
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更新日期:2012-11-20 00:00:00
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pub_type: 杂志文章
doi:10.1186/1465-9921-12-37
更新日期:2011-03-30 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12931-020-01523-9
更新日期:2020-09-29 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/s12931-018-0798-8
更新日期:2018-05-10 00:00:00
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pub_type: 社论
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pub_type: 杂志文章
doi:10.1186/1465-9921-8-90
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:10.1186/s12931-016-0408-6
更新日期:2016-07-26 00:00:00
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pub_type: 信件
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更新日期:2012-09-19 00:00:00
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pub_type: 杂志文章
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更新日期:2016-11-04 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章,meta分析
doi:10.1186/s12931-020-1309-2
更新日期:2020-02-06 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章
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更新日期:2017-08-29 00:00:00
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pub_type: 杂志文章
doi:10.1186/1465-9921-11-71
更新日期:2010-06-07 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-08-10 00:00:00
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pub_type: 杂志文章,评审
doi:10.1186/s12931-019-1229-1
更新日期:2019-12-04 00:00:00
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journal_title:Respiratory research
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2014-08-20 00:00:00