Classification of the Gut Microbiota of Patients in Intensive Care Units During Developmentof Sepsis and Septic Shock
- Author:
Liu WANGLIN
1
;
Cheng MINGYUE
;
Li JINMAN
;
Zhang PENG
;
Fan HANG
;
Hu QINGHE
;
Han MAOZHEN
;
Su LONGXIANG
;
He HUAIWU
;
Tong YIGANG
;
Ning KANG
;
Long YUN
Author Information
1. Department of Critical Care Medicine,Peking Union Medical College Hospital,Beijing 100730,China
- Keywords:
Sepsis;
Septic shock;
Gut microbiota;
Enterotype;
Precision medicine
- From:
Genomics, Proteomics & Bioinformatics
2020;18(6):696-707
- CountryChina
- Language:Chinese
-
Abstract:
The gut microbiota of intensive care unit (ICU) patients displays extreme dysbiosis asso-ciated with increased susceptibility to organ failure, sepsis, and septic shock. However, such dysbio-sis is difficult to characterize owing to the high dimensional complexity of the gut microbiota. We tested whether the concept of enterotype can be applied to the gut microbiota of ICU patients to describe the dysbiosis. We collected 131 fecal samples from 64 ICU patients diagnosed with sepsis or septic shock and performed 16S rRNA gene sequencing to dissect their gut microbiota compo-sitions. During the development of sepsis or septic shock and during various medical treatments, the ICU patients always exhibited two dysbiotic microbiota patterns, or ICU-enterotypes, which could not be explained by host properties such as age, sex, and body mass index, or external stressors such as infection site and antibiotic use. ICU-enterotype I (ICU E1) comprised predominantly Bac-teroides and an unclassified genus of Enterobacteriaceae, while ICU-enterotype Ⅱ(ICU E2) com-prised predominantly Enterococcus. Among more critically ill patients with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores > 18, septic shock was more likely to occur with ICU E1 (P = 0.041). Additionally, ICU E1 was correlated with high serum lactate levels (P = 0.007). Therefore, different patterns of dysbiosis were correlated with different clinicaloutcomes, suggesting that ICU-enterotypes should be diagnosed as independent clinical indices. Thus, the microbial-based human index classifier we propose is precise and effective for timely mon-itoring of ICU-enterotypes of individual patients. This work is a first step toward precision medicine for septic patients based on their gut microbiota profiles.
