GUT MICROBIOTA CHANGE AND TIME OF RESTORE IN INTENSIVE CARE THERAPY: A CASE REPORT

F. Borgo, E. Borghi, S. Marzorati, G. Iapichino, G. Morace
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Abstract

Exposure of gut microbiota to antibiotics can promote antibiotic resistance and development of diseases caused by multi-drug-resistant organisms. Here we present a case of a 54-year-old male patient with a diagnosis of acute cholecystitis with significant biliary duct leakage, admitted to Intensive Care Unit (ICU) due to a septic syndrome after surgery. Fecal microbial population was analyzed by DGGE and Real Time PCR during and after a combined antibiotic therapy and enteral nutritional feeding. Gut microbiota dysbiosis was demonstrated during ICU recovery. After antibiotic therapy discontinuation and the switch to normal diet, microbial gut population gradually increased up to values comparable with those of a healthy subject. Bifidobacterium spp. took longer to re-stabilize, reaching normal value after two weeks. Our case report corroborates the resilient nature of gut microbiota, but points out the long time needed to recover after antibiotic treatment, paving the way to supplementation with key probiotic species.
重症监护治疗中肠道菌群变化与恢复时间1例报告
肠道微生物群暴露于抗生素可促进抗生素耐药性和由多重耐药生物引起的疾病的发展。在此,我们报告一例54岁男性患者,诊断为急性胆囊炎伴胆管明显渗漏,手术后因脓毒症综合征入院重症监护病房(ICU)。采用DGGE和Real Time PCR分析抗生素联合肠内营养喂养期间和之后的粪便微生物数量。在ICU康复期间证实了肠道菌群失调。在停止抗生素治疗并转向正常饮食后,肠道微生物数量逐渐增加到与健康受试者相当的值。双歧杆菌需要更长的时间才能重新稳定下来,两周后达到正常水平。我们的病例报告证实了肠道菌群的弹性,但指出抗生素治疗后需要很长时间才能恢复,为补充关键益生菌物种铺平了道路。
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