B Salzberger1, C Rauscher2. 1. Stabsstelle Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Deutschland. bernd.salzberger@ukr.de. 2. Lehr- und Forschungseinheit Allgemeinmedizin, Universitätsklinikum Regensburg, Regensburg, Deutschland.
Abstract
BACKGROUND: The complexity and diversity of the human intestinal microbiome has only recently been characterized. The multiple metabolic and immunologic effects of the bacterial flora have demonstrated the symbiosis between the microbiome and its host. This symbiosis is disturbed in a multitude of diseases, especially in critically ill patients. OBJECTIVES: A review of the changes in the intestinal microbiome of critically ill patients and the use of probiotics. MATERIAL AND METHODS: Nonsystematic literature search in PubMed on the topics: (1) changes in the intestinal microbiome in critically ill patients, (2) interventions using probiotics in critically ill patients, and (3) use of fecal transplantation in Clostridium difficile colitis. RESULTS: Trauma, sepsis, systemic inflammatory response syndrome, and other conditions lead to shifts in the composition of the intestinal microbiome, which are correlated with clinical outcome. The most obvious change is a profound loss of obligate anaerobe bacteria, leading also to metabolic changes. Probiotics have been used in several studies and show efficacy in the reduction of infectious complication but not in overall mortality. C. difficile colitis as the model disease for a disturbed microbiome can be treated effectively by transfer of donor feces, which also restores the diversity of the microbiome. CONCLUSION: Taking into account the successful intervention of fecal transplantation on the intestinal microbiome, new products developed using the current knowledge of the intestinal microbiome could be more effective.
BACKGROUND: The complexity and diversity of the human intestinal microbiome has only recently been characterized. The multiple metabolic and immunologic effects of the bacterial flora have demonstrated the symbiosis between the microbiome and its host. This symbiosis is disturbed in a multitude of diseases, especially in critically illpatients. OBJECTIVES: A review of the changes in the intestinal microbiome of critically illpatients and the use of probiotics. MATERIAL AND METHODS: Nonsystematic literature search in PubMed on the topics: (1) changes in the intestinal microbiome in critically illpatients, (2) interventions using probiotics in critically illpatients, and (3) use of fecal transplantation in Clostridium difficilecolitis. RESULTS:Trauma, sepsis, systemic inflammatory response syndrome, and other conditions lead to shifts in the composition of the intestinal microbiome, which are correlated with clinical outcome. The most obvious change is a profound loss of obligate anaerobe bacteria, leading also to metabolic changes. Probiotics have been used in several studies and show efficacy in the reduction of infectious complication but not in overall mortality. C. difficilecolitis as the model disease for a disturbed microbiome can be treated effectively by transfer of donor feces, which also restores the diversity of the microbiome. CONCLUSION: Taking into account the successful intervention of fecal transplantation on the intestinal microbiome, new products developed using the current knowledge of the intestinal microbiome could be more effective.
Authors: G Cammarota; L Masucci; G Ianiro; S Bibbò; G Dinoi; G Costamagna; M Sanguinetti; A Gasbarrini Journal: Aliment Pharmacol Ther Date: 2015-03-01 Impact factor: 8.171
Authors: Paul Moayyedi; Michael G Surette; Peter T Kim; Josie Libertucci; Melanie Wolfe; Catherine Onischi; David Armstrong; John K Marshall; Zain Kassam; Walter Reinisch; Christine H Lee Journal: Gastroenterology Date: 2015-04-07 Impact factor: 22.682
Authors: Els van Nood; Anne Vrieze; Max Nieuwdorp; Susana Fuentes; Erwin G Zoetendal; Willem M de Vos; Caroline E Visser; Ed J Kuijper; Joep F W M Bartelsman; Jan G P Tijssen; Peter Speelman; Marcel G W Dijkgraaf; Josbert J Keller Journal: N Engl J Med Date: 2013-01-16 Impact factor: 91.245
Authors: Noortje G Rossen; John K MacDonald; Elisabeth M de Vries; Geert R D'Haens; Willem M de Vos; Erwin G Zoetendal; Cyriel Y Ponsioen Journal: World J Gastroenterol Date: 2015-05-07 Impact factor: 5.742
Authors: Nicola Segata; Susan Kinder Haake; Peter Mannon; Katherine P Lemon; Levi Waldron; Dirk Gevers; Curtis Huttenhower; Jacques Izard Journal: Genome Biol Date: 2012-06-14 Impact factor: 13.583