Head injury profoundly affects gut microbiota homeostasis: Results of a pilot study

Head injury (HI) induces a hypercatabolic state, dysimmunity, and septic complications that increase morbidity and mortality. Although compromised immune function is usually incriminated in infection occurrence, gut dysbiosis could also be involved in this phenomenon and, to our knowledge, has never been considered. To assess if HI could affect microbiota, we explored the impact of HI on intestinal microbiota in a rodent model of fluid percussion.

Nineteen rats were randomly assigned to two groups: Healthy rats fed ad libitum (n = 7) and HI rats (n = 12), which received standard enteral nutrition for 4 d. Four days after HI, rats were euthanized and cecal contents were sampled. Cecal microbiota was assessed using real-time quantitative polymerase chain reaction.

HI significantly decreased the cecal content of strict anaerobic groups, Bacteroides/Prevotella group (HI 8.9 versus healthy controls 9.3 median log₁₀ colony forming units [CFU]/g, P = 0.007), Clostridium cluster XIVab (HI 7.9 versus healthy controls 8.9 median log₁₀ CFU/g, P = 0.002), Lactobacillus/Leuconostoc group (HI 8.5 versus healthy controls 9.4 median log₁₀ CFU/g, P = 0.044), and Bifidobacterium sp. (HI 3.0 versus healthy controls 8.2 median log₁₀ CFU/g, P < 0.001). In contrast, colonization by Escherichia coli was dramatically increased (HI 10.5 versus healthy controls 7.0 median log₁₀ CFU/g, P < 0.001).

HI profoundly modified the gut microbiota homeostasis and thus could contribute to infection in head trauma patients. These preliminary results open a new field of research in the management of patients with HI.