Host Microbiome Threats in the Intensive Care Unit.

Area of Science:

• Microbiology
• Critical Care Medicine
• Host-Microbiome Interactions

Background:

• The human microbiome is crucial for host homeostasis and adaptation.
• Acute illness and injury can disrupt microbial balance, favoring pathogens.
• Intensive care unit (ICU) environments and treatments further exacerbate microbiome derangement.

Purpose of the Study:

• To review how ICU practices impact the human microbiome.
• To discuss the implications of microbiome disruption in critically ill patients.
• To explore current and emerging strategies for microbiome protection and restoration.

Main Methods:

• Literature review of studies on ICU interventions and microbiome alterations.
• Analysis of the effects of antibiotics, nutrition, acid suppression, and vasopressors on microbial ecology.
• Examination of the role of ICU microbial environment and multi-drug-resistant pathogens.

Main Results:

• ICU therapies like antibiotics and acid suppression significantly alter microbiota diversity and composition.
• The ICU environment itself contributes to patient microbiome shifts, including pathogen acquisition.
• Delayed nutrition and vasopressors also negatively impact the gut microbiome.

Conclusions:

• ICU interventions pose a significant threat to microbiome integrity.
• Restoring a healthy microbiome is essential for patient recovery and preventing secondary infections.
• Future approaches will likely integrate microbiome-directed therapeutics with existing infection control and antibiotic stewardship.