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Dramatic changes of the gut flora immediately after severe and sudden insults

Mineji Hayakawa1, Takashi Asahara, Naomi Henzan

  • 1Emergency and Critical Care Center, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8648, Japan. mineji@dream.com

Digestive Diseases and Sciences
|March 9, 2011
PubMed

Insights

Critically ill patients experience immediate gut flora disruption after severe illness, with decreased beneficial bacteria and short-chain fatty acids. Harmful bacteria increase, and normal gut microbiota does not recover within two weeks.

Area of Science:

  • Microbiology
  • Critical Care Medicine
  • Gastroenterology

Background:

  • The gut microbiota plays a vital role in maintaining host homeostasis.
  • Early-phase changes in gut flora during critical illness remain largely uncharacterized.

Purpose of the Study:

  • To investigate alterations in the gut microbiota during the early stages of severe insult in critically ill patients.

Main Methods:

  • Fecal samples were collected from 15 critically ill patients within 6 hours of admission and serially for 14 days.
  • A control group of 12 healthy volunteers provided fecal samples.
  • Bacterial counts and short-chain fatty acid concentrations were analyzed.

Main Results:

  • On admission (day 0), total bacterial counts in patients were significantly reduced compared to controls, with notable decreases in obligate anaerobes and Lactobacillus.
  • Major short-chain fatty acid concentrations were also significantly lower in patients on day 0.
  • While Enterococcus and Pseudomonas populations increased, the gut flora and short-chain fatty acid levels showed no recovery within the 14-day study period.

Conclusions:

  • Severe insults rapidly alter the gut flora in critically ill patients.
  • A sharp decline in major short-chain fatty acids correlates with gut flora destruction.
  • The gut microbiota and short-chain fatty acid levels remained impaired for at least two weeks post-admission, with a concurrent rise in potentially harmful bacteria.
Abstract

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