The condition of the intestinal microflora worsens sharply in intensive care. Free Technical Library News

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The state of the intestinal microflora deteriorates sharply in intensive care

16.09.2016

Dr. Paul Wischmeyer (Paul Wischmeyer) and his colleagues from the University of Colorado (USA) found that the number of beneficial bacteria in the body of patients in intensive care units is reduced compared to healthy people. This increases the risk of nosocomial infections, which can lead to sepsis, multiple organ failure, and even death in this situation.

What determines the health of the human intestinal microflora is still not sufficiently studied. However, the researchers guessed that a severe illness requiring a stay in the intensive care unit leads to the loss of beneficial microflora that supports the work of the human immune system. A new study by American scientists has found evidence for this hypothesis.

"The results were exactly what we feared. We saw massive depletion of normal, health-promoting species," said Paul Wischmeyer. He works in a laboratory that deals with the nutrition of critically ill patients. Dr. Wischmeyer noted that typical medical procedures used in intensive care units - aggressive antibiotic therapy, blood pressure medications, and "table number 0" (complete suspension of nutrition) - have a negative impact on the population of beneficial intestinal bacteria.

Understanding how these changes affect patient outcomes could be helpful in developing targeted interventions to restore bacterial balance. This, in turn, can reduce the risk of infection by pathogens.

Scientists analyzed skin, stool and mouth swabs from 115 patients in intensive care units at four hospitals in the United States and Canada. Moreover, the analysis was carried out twice: the first time 48 hours after collection, and then 10 days later in the intensive care unit (or when the patient had already been discharged). The scientists also recorded what the patients ate, what treatment the patients received, and what infections they had.

The researchers compared the results with data from apparently healthy people. They report that tests on ICU patients have shown lower levels of Firmicutes and Bacteroidetes bacteria, the two largest groups of microbes in the human gut, and an increase in proteobacteria, which include many pathogenic species.

Now that researchers have begun to understand how the composition of the gut microflora of patients in intensive care units changes, the next step should be to use this data to develop methods to maintain a beneficial human microbiome, including the use of probiotics, according to Dr. Wischmeyer.

The lead author of the study notes that everyone involved in the project, including nutritionists, pharmacists, statisticians, critical care physicians, and programmers, worked largely on a voluntary basis without significant funding to study human microbiome changes in intensive care units.

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