Impact of digestive and oropharyngeal decontamination on the intestinal microbiota in ICU patients
Open Access
- 16 March 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Intensive Care Medicine
- Vol. 36 (8), 1394-1402
- https://doi.org/10.1007/s00134-010-1826-4
Abstract
Purpose Selective digestive microbial decontamination (SDD) is hypothesized to benefit patients in intensive care (ICU) by suppressing Gram-negative potential pathogens from the colon without affecting the anaerobic intestinal microbiota. The purpose of this study was to provide more insight to the effects of digestive tract and oropharyngeal decontamination on the intestinal microbiota by means of a prospective clinical trial in which faecal samples were collected from ICU patients for intestinal microbiota analysis. Methods The faecal samples were collected from ICU patients enrolled in a multicentre trial to study the outcome of SDD and selective oral decontamination (SOD) in comparison with standard care (SC). Fluorescent in situ hybridization (FISH) was used to analyze the faecal microbiota. The numbers of bacteria from different bacterial groups were compared between the three regimens. Results The total counts of bacteria per gram faeces did not differ between regimens. The F. prausnitzii group of bacteria, representing an important group among intestinal microbiota, was significantly reduced in the SDD regimen compared to the SC and SOD. The Enterobacteriaceae were significantly suppressed during SDD compared to both SOD and SC; enterococci increased in SDD compared to both other regimens. Conclusions The composition of the intestinal microbiota is importantly affected by SDD. The F. prausnitzii group was significantly suppressed during SDD. This group of microbiota is a predominant producer of butyrate, the main energy source for colonocytes. Reduction of this microbiota is an important trade-off while reducing gram-negative bacteria by SDD.Keywords
This publication has 48 references indexed in Scilit:
- Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patientsProceedings of the National Academy of Sciences of the United States of America, 2008
- Vancomycin-resistant enterococci exploit antibiotic-induced innate immune deficitsNature, 2008
- Reduced Dietary Intake of Carbohydrates by Obese Subjects Results in Decreased Concentrations of Butyrate and Butyrate-Producing Bacteria in FecesApplied and Environmental Microbiology, 2007
- Fluorescent in situ hybridization with specific DNA probes offers adequate detection of Enterococcus faecalis and Enterococcus faecium in clinical samplesJournal of Medical Microbiology, 2005
- Global Spread of Vancomycin-resistantEnterococcus faeciumfrom Distinct Nosocomial Genetic ComplexEmerging Infectious Diseases, 2005
- Mechanisms by Which Anaerobic Microbiota Inhibit the Establishment in Mice of Intestinal Colonization by Vancomycin‐ResistantEnterococcusThe Journal of Infectious Diseases, 2005
- Temporal stability analysis of the microbiota in human feces by denaturing gradient gel electrophoresis using universal and group-specific 16S rRNA gene primersFEMS Microbiology Ecology, 2004
- Growth requirements and fermentation products of Fusobacterium prausnitzii, and a proposal to reclassify it as Faecalibacterium prausnitzii gen. nov., comb. novInternational Journal of Systematic and Evolutionary Microbiology, 2002
- Clinical use of selective decontamination: The conceptIntensive Care Medicine, 1990
- APACHE IICritical Care Medicine, 1985