Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study

BACKGROUND Gut bacterial diversity is decreased in a proportion of patients with septic shock. We attempted to validate the hypothesis that low bacterial diversity increases the risk of mortality. MATERIAL AND METHODS All patients with septic shock seen at 2 medical center from 2016 through 2019 wer...

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Published in:Medical science monitor 2019-10, Vol.25, p.7376-7382
Main Authors: Yin, Lei, Wan, You-Dong, Pan, Xin-Ting, Zhou, Chang-Yong, Lin, Nan, Ma, Cheng-Tai, Yao, Jian, Su, Zhe, Wan, Chao, Yu, Yan-Wu, Zhu, Rui-Xue
Format: Article
Language:English
Subjects:
Aged
Bacteria - genetics
China
Clinical Research
Cohort Studies
Feces - microbiology
Female
Gastrointestinal Microbiome - physiology
Gastrointestinal Tract - microbiology
High-Throughput Nucleotide Sequencing
Humans
Kaplan-Meier Estimate
Male
Microbiota - genetics
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Shock, Septic - microbiology
Shock, Septic - mortality
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container_title Medical science monitor
container_volume 25
creator Yin, Lei
Wan, You-Dong
Pan, Xin-Ting
Zhou, Chang-Yong
Lin, Nan
Ma, Cheng-Tai
Yao, Jian
Su, Zhe
Wan, Chao
Yu, Yan-Wu
Zhu, Rui-Xue
description BACKGROUND Gut bacterial diversity is decreased in a proportion of patients with septic shock. We attempted to validate the hypothesis that low bacterial diversity increases the risk of mortality. MATERIAL AND METHODS All patients with septic shock seen at 2 medical center from 2016 through 2019 were included in this cohort study. Total DNA was isolated from stool, and high-throughput sequencing was performed. Clinical data were extracted from patient medical records and hospital databases. Patients were grouped by gut microbiota bacterial diversity (measured by Shannon diversity index) on presentation. We used logistic regression analysis to evaluate the risk of 28-day mortality in septic patients with low Shannon diversity index. RESULTS Of the 150 patients enrolled in this study, low bacterial diversity (Shannon index
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We attempted to validate the hypothesis that low bacterial diversity increases the risk of mortality. MATERIAL AND METHODS All patients with septic shock seen at 2 medical center from 2016 through 2019 were included in this cohort study. Total DNA was isolated from stool, and high-throughput sequencing was performed. Clinical data were extracted from patient medical records and hospital databases. Patients were grouped by gut microbiota bacterial diversity (measured by Shannon diversity index) on presentation. We used logistic regression analysis to evaluate the risk of 28-day mortality in septic patients with low Shannon diversity index. RESULTS Of the 150 patients enrolled in this study, low bacterial diversity (Shannon index &lt;3.0) was found in 80 patients and normal diversity (Shannon index ≥3.0) was found in 70 patients. Low diversity was associated with a higher unadjusted mortality risk, compared to those with normal diversity (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.35-2.83). However, this result became non-significant after adjusting the confounding factors such as age, sex, severity of disease, comorbid status, usage of probiotics, enteral nutrition, and antimicrobial drugs (OR 1.93, 95% CI 0.55-2.69). CONCLUSIONS Our study does not support that low gut bacterial diversity is an independent risk factor for mortality in intensive care unit patients with septic shock.</description><identifier>ISSN: 1643-3750</identifier><identifier>ISSN: 1234-1010</identifier><identifier>EISSN: 1643-3750</identifier><identifier>DOI: 10.12659/MSM.916808</identifier><identifier>PMID: 31574078</identifier><language>eng</language><publisher>United States: International Scientific Literature, Inc</publisher><subject>Aged ; Bacteria - genetics ; China ; Clinical Research ; Cohort Studies ; Feces - microbiology ; Female ; Gastrointestinal Microbiome - physiology ; Gastrointestinal Tract - microbiology ; High-Throughput Nucleotide Sequencing ; Humans ; Kaplan-Meier Estimate ; Male ; Microbiota - genetics ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Shock, Septic - microbiology ; Shock, Septic - mortality</subject><ispartof>Medical science monitor, 2019-10, Vol.25, p.7376-7382</ispartof><rights>Med Sci Monit, 2019 2019</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-3f666224d9e0a0e2a9bf64e1687c94970771710633f0ec883b68a59bbde078663</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788322/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788322/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31574078$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yin, Lei</creatorcontrib><creatorcontrib>Wan, You-Dong</creatorcontrib><creatorcontrib>Pan, Xin-Ting</creatorcontrib><creatorcontrib>Zhou, Chang-Yong</creatorcontrib><creatorcontrib>Lin, Nan</creatorcontrib><creatorcontrib>Ma, Cheng-Tai</creatorcontrib><creatorcontrib>Yao, Jian</creatorcontrib><creatorcontrib>Su, Zhe</creatorcontrib><creatorcontrib>Wan, Chao</creatorcontrib><creatorcontrib>Yu, Yan-Wu</creatorcontrib><creatorcontrib>Zhu, Rui-Xue</creatorcontrib><title>Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study</title><title>Medical science monitor</title><addtitle>Med Sci Monit</addtitle><description>BACKGROUND Gut bacterial diversity is decreased in a proportion of patients with septic shock. We attempted to validate the hypothesis that low bacterial diversity increases the risk of mortality. MATERIAL AND METHODS All patients with septic shock seen at 2 medical center from 2016 through 2019 were included in this cohort study. Total DNA was isolated from stool, and high-throughput sequencing was performed. Clinical data were extracted from patient medical records and hospital databases. Patients were grouped by gut microbiota bacterial diversity (measured by Shannon diversity index) on presentation. We used logistic regression analysis to evaluate the risk of 28-day mortality in septic patients with low Shannon diversity index. RESULTS Of the 150 patients enrolled in this study, low bacterial diversity (Shannon index &lt;3.0) was found in 80 patients and normal diversity (Shannon index ≥3.0) was found in 70 patients. Low diversity was associated with a higher unadjusted mortality risk, compared to those with normal diversity (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.35-2.83). However, this result became non-significant after adjusting the confounding factors such as age, sex, severity of disease, comorbid status, usage of probiotics, enteral nutrition, and antimicrobial drugs (OR 1.93, 95% CI 0.55-2.69). CONCLUSIONS Our study does not support that low gut bacterial diversity is an independent risk factor for mortality in intensive care unit patients with septic shock.</description><subject>Aged</subject><subject>Bacteria - genetics</subject><subject>China</subject><subject>Clinical Research</subject><subject>Cohort Studies</subject><subject>Feces - microbiology</subject><subject>Female</subject><subject>Gastrointestinal Microbiome - physiology</subject><subject>Gastrointestinal Tract - microbiology</subject><subject>High-Throughput Nucleotide Sequencing</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Microbiota - genetics</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Shock, Septic - microbiology</subject><subject>Shock, Septic - mortality</subject><issn>1643-3750</issn><issn>1234-1010</issn><issn>1643-3750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpVkEFPAjEQhRujEURP3k3vZrHd7rZdDyaAiiYQTVbPTbfblSpsSVsw_HurKMHTzGTefDPzADjHqI9TmhdX03LaLzDliB-ALqYZSQjL0eFe3gEn3r8jlHKK8mPQIThnGWK8C6qB91YZGYxt4VCHT61bOF4FOJQqaGfkHN6atXbehA2UbQ2n1gU5_65MC0u9DEbBcmbVB3yOEN0Gfw0HcGRnUQfLsKo3p-CokXOvz35jD7ze372MHpLJ0_hxNJgkimQ8JKShlKZpVhcaSaRTWVQNzXT8i6kiKxhiDDOMKCEN0opzUlEu86Kqah0_oZT0wM2Wu1xVC12reIuTc7F0ZiHdRlhpxP9Oa2biza4FZZGWphFwuQUoZ713utnNYiR-rBbRarG1Oqov9tfttH_eki9Ui3qB</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Yin, Lei</creator><creator>Wan, You-Dong</creator><creator>Pan, Xin-Ting</creator><creator>Zhou, Chang-Yong</creator><creator>Lin, Nan</creator><creator>Ma, Cheng-Tai</creator><creator>Yao, Jian</creator><creator>Su, Zhe</creator><creator>Wan, Chao</creator><creator>Yu, Yan-Wu</creator><creator>Zhu, Rui-Xue</creator><general>International Scientific Literature, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20191001</creationdate><title>Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study</title><author>Yin, Lei ; Wan, You-Dong ; Pan, Xin-Ting ; Zhou, Chang-Yong ; Lin, Nan ; Ma, Cheng-Tai ; Yao, Jian ; Su, Zhe ; Wan, Chao ; Yu, Yan-Wu ; Zhu, Rui-Xue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-3f666224d9e0a0e2a9bf64e1687c94970771710633f0ec883b68a59bbde078663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Bacteria - genetics</topic><topic>China</topic><topic>Clinical Research</topic><topic>Cohort Studies</topic><topic>Feces - microbiology</topic><topic>Female</topic><topic>Gastrointestinal Microbiome - physiology</topic><topic>Gastrointestinal Tract - microbiology</topic><topic>High-Throughput Nucleotide Sequencing</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Microbiota - genetics</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Shock, Septic - microbiology</topic><topic>Shock, Septic - mortality</topic><toplevel>online_resources</toplevel><creatorcontrib>Yin, Lei</creatorcontrib><creatorcontrib>Wan, You-Dong</creatorcontrib><creatorcontrib>Pan, Xin-Ting</creatorcontrib><creatorcontrib>Zhou, Chang-Yong</creatorcontrib><creatorcontrib>Lin, Nan</creatorcontrib><creatorcontrib>Ma, Cheng-Tai</creatorcontrib><creatorcontrib>Yao, Jian</creatorcontrib><creatorcontrib>Su, Zhe</creatorcontrib><creatorcontrib>Wan, Chao</creatorcontrib><creatorcontrib>Yu, Yan-Wu</creatorcontrib><creatorcontrib>Zhu, Rui-Xue</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical science monitor</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yin, Lei</au><au>Wan, You-Dong</au><au>Pan, Xin-Ting</au><au>Zhou, Chang-Yong</au><au>Lin, Nan</au><au>Ma, Cheng-Tai</au><au>Yao, Jian</au><au>Su, Zhe</au><au>Wan, Chao</au><au>Yu, Yan-Wu</au><au>Zhu, Rui-Xue</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study</atitle><jtitle>Medical science monitor</jtitle><addtitle>Med Sci Monit</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>25</volume><spage>7376</spage><epage>7382</epage><pages>7376-7382</pages><issn>1643-3750</issn><issn>1234-1010</issn><eissn>1643-3750</eissn><abstract>BACKGROUND Gut bacterial diversity is decreased in a proportion of patients with septic shock. 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Low diversity was associated with a higher unadjusted mortality risk, compared to those with normal diversity (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.35-2.83). However, this result became non-significant after adjusting the confounding factors such as age, sex, severity of disease, comorbid status, usage of probiotics, enteral nutrition, and antimicrobial drugs (OR 1.93, 95% CI 0.55-2.69). CONCLUSIONS Our study does not support that low gut bacterial diversity is an independent risk factor for mortality in intensive care unit patients with septic shock.</abstract><cop>United States</cop><pub>International Scientific Literature, Inc</pub><pmid>31574078</pmid><doi>10.12659/MSM.916808</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Bacteria - genetics
China
Clinical Research
Cohort Studies
Feces - microbiology
Female
Gastrointestinal Microbiome - physiology
Gastrointestinal Tract - microbiology
High-Throughput Nucleotide Sequencing
Humans
Kaplan-Meier Estimate
Male
Microbiota - genetics
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Shock, Septic - microbiology
Shock, Septic - mortality
title Association Between Gut Bacterial Diversity and Mortality in Septic Shock Patients: A Cohort Study
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