The Microbiome and Metabolome of the Gut of Children with Sepsis and Septic Shock

BACKGROUND: There is limited understanding of alteration of gut microbiota and metabolome in children with sepsis/septic shock.

METHODS: In this prospective observational study carried out in a pediatric intensive care unit of a tertiary care center from 2020 to 2022, patients aged <17 years with sepsis/septic shock and healthy children (HC) were enrolled. We characterized the gut bacterial compositions by metagenome sequencing and metabolomes by untargeted gas chromatography-mass spectrometry. The primary outcome was to compare the gut microbiota and metabolome of children with sepsis/septic shock with that of HC. The Firmicutes/Bacteroidetes (F/B) ratio was compared between children with sepsis/septic shock and HC. Key secondary outcomes were to evaluate association of factors associated with a low F/B ratio in children with sepsis/septic shock.

RESULTS: A total of 40 children (63% boys) (15 children with sepsis and septic shock and 10 healthy children) with a median (IQR) age of 5.5 (1.5, 10) years were enrolled. In the fecal microbiota, the α-diversity index including Shannon and Simpson indices of the sepsis/septic shock groups was significantly lower than that of the HC. The samples lacked beneficial Bifidobacterium spp. and were dominated by Bacteroides, Enterobacteriaceae, and Enterococcaceae. There was reduction in short-chain fatty acids (SCFAs) in patients with sepsis/septic shock as compared to healthy children. A lower F/B ratio (≤1.57) of the gut microbiota discriminated well between children with sepsis/septic shock and HC. Factors associated with lower F/B ratio were male gender, clinical GI dysfunction, elevated inflammatory markers, and higher organ failure scores.

CONCLUSION: There were significant alterations in the gut microbiota and metabolome in children with sepsis/septic shock as compared to healthy children. Larger study is needed to confirm these exploratory findings and develop potential therapeutic targets that will improve outcomes in children with sepsis/septic shock.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - year:2023

Enthalten in:

Journal of intensive care medicine - (2023) vom: 10. Dez., Seite 8850666231216361

Sprache:

Englisch

Beteiligte Personen:

Sankar, Jhuma [VerfasserIn]
Thakral, Vaishali [VerfasserIn]
Bharadwaj, Kanchan [VerfasserIn]
Agarwal, Sheetal [VerfasserIn]
Kabra, Sushil Kumar [VerfasserIn]
Lodha, Rakesh [VerfasserIn]
Rathore, Sumit [VerfasserIn]

Links:

Volltext

Themen:

Gastrointestinal dysfunction
Gut microbiota
Journal Article
Metabolome
Sepsis
Septic shock
Short-chain fatty acids
Taxa

Anmerkungen:

Date Revised 11.12.2023

published: Print-Electronic

Citation Status Publisher

doi:

10.1177/08850666231216361

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365639710