Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2376
Peer-review started: January 16, 2021
First decision: February 10, 2021
Revised: February 23, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 21, 2021
Sepsis is a common disease in intensive care units, with high morbidity and mortality. Intestinal microecology plays a vital part in the development and progression of this disease, possibly because sepsis and its treatment cause specific changes in the composition of the intestinal flora.
To investigate the characteristics of intestinal flora disturbance in sepsis patients treated with antibiotics.
In this prospective comparative study, we enrolled ten patients with sepsis (sepsis group), hospitalized in the Department of Critical Care Medicine of the General Hospital, Ningxia Medical University, China (a class IIIa general hospital) from February 2017 to June 2017; ten patients without sepsis hospitalized in the same period (non-sepsis group) and ten healthy individuals (control group) were also enrolled. Fecal samples collected from the three groups were subjected to 16S rRNA gene sequencing and the intestinal flora diversity, structure, and composition were determined. Additionally, the dynamics of the intestinal flora diversity, structure, and composition in sepsis patients were investigated via 16S rRNA gene sequencing of samples collected 0 d, 3 d, and 7 d after admittance to the intensive care unit. Correlations between the serum levels of procalcitonin, endotoxin, diamine oxidase, and D-lactic acid and the intestinal flora composition of sepsis patients were also investigated.
Compared with the healthy control group, sepsis and non-sepsis patients showed reduced intestinal flora α-diversity and a distinct flora structure, with Firmicutes as the dominant phylum, and significantly decreased proportions of Bacte
Sepsis patients in intensive care units show dysbiosis, lasting for at least 1 wk.
Core Tip: As the largest reservoir of bacteria and endotoxins in the body, the intestinal tract is regarded as the “engine” of sepsis and multiple organ dysfunction. Through 16S rRNA gene sequencing, we observed that intestinal flora disturbance occurs in sepsis patients. Notably, here, we revealed for the first time the intestinal flora dynamic changes in sepsis patients during treatment. We found that the abundance of some intestinal bacteria in sepsis patients significantly correlated with infection- and intestinal barrier-related clinical indicators. These findings add to the understanding of the intestinal flora in sepsis, providing a basis for the reversal of dysbiosis.