Gut microbiota differs between ICU patients admitted for cardiac arrest and other causes: a secondary, propensity-matched cohort analysis

Authors:
  • TGThe Gut Microbiota Working Group
    The Gut Microbiota Working Group
  • LFLorin Fröhlich
    Lorin Fröhlich
  • TSTania Soccorsi
    Tania Soccorsi
  • NSNoémie Suh
    Noémie Suh

Abstract
Background: Critical illness is known to reduce gut microbiota (GM) diversity, a change associated with adverse outcomes. Among potential mechanisms, splanchnic hypoperfusion may play a key role. Cardiac arrest (CA), characterized by transient global hypoperfusion, provides a relevant model to explore this effect. Results: We conducted a secondary, propensity score-matched analysis of a cohort study investigating GM changes during early intensive care unit stay. Stool samples were collected at ICU admission (S1) and at least 24 h later (S2). GM profiling was performed using 16S rRNA sequencing. Shannon diversity index and taxonomic composition were compared between CA and non-CA patients. Propensity score matching and generalized linear models (GLM) were used to adjust for confounding. A total of 26 patients were included in this analysis (13 CA, 13 matched controls). At S1, CA patients had significantly lower GM diversity (Shannon index: 3.6 [3.0–3.8] vs. 4.3 [3.9–4.8], p = 0.019). This was confirmed in the GLM (β = − 0.30, SE 0.12, p = 0.022). At S2, diversity remained lower (3.2 [2.7–3.8] vs. 4.0 [3.7–4.3], p = 0.064). While no global compositional shifts were observed between groups, differences in the abundance of specific taxa were noted. Conclusion: CA is associated with reduced GM diversity in the first few days of intensive care unit admission compared to non-CA patients, supporting a role for splanchnic hypoperfusion in GM modulation. Further research should investigate clinical consequences and evaluate microbiota-targeted interventions in this high-risk population.
Funding Information
  • University of Geneva

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