| Title |
Pathogen colonization of the gastrointestinal microbiome at intensive care unit admission and risk for subsequent death or infection
|
|---|---|
| Published in |
Intensive Care Medicine, June 2018
|
| DOI | 10.1007/s00134-018-5268-8 |
| Pubmed ID | |
| Authors |
Daniel E. Freedberg, Margaret J. Zhou, Margot E. Cohen, Medini K. Annavajhala, Sabrina Khan, Dagmara I. Moscoso, Christian Brooks, Susan Whittier, David H. Chong, Anne-Catrin Uhlemann, Julian A. Abrams |
| Abstract |
Loss of colonization resistance within the gastrointestinal microbiome facilitates the expansion of pathogens and has been associated with death and infection in select populations. We tested whether gut microbiome features at the time of intensive care unit (ICU) admission predict death or infection. This was a prospective cohort study of medical ICU adults. Rectal surveillance swabs were performed at admission, selectively cultured for vancomycin-resistant Enterococcus (VRE), and assessed using 16S rRNA gene sequencing. Patients were followed for 30 days for death or culture-proven bacterial infection. Of 301 patients, 123 (41%) developed culture-proven infections and 76 (25%) died. Fecal biodiversity (Shannon index) did not differ based on death or infection (p = 0.49). The presence of specific pathogens at ICU admission was associated with subsequent infection with the same organism for Escherichia coli, Pseudomonas spp., Klebsiella spp., and Clostridium difficile, and VRE at admission was associated with subsequent Enterococcus infection. In a multivariable model adjusting for severity of illness, VRE colonization and Enterococcus domination (≥ 30% 16S reads) were both associated with death or all-cause infection (aHR 1.46, 95% CI 1.06-2.00 and aHR 1.47, 95% CI 1.00-2.19, respectively); among patients without VRE colonization, Enterococcus domination was associated with excess risk of death or infection (aHR 2.13, 95% CI 1.06-4.29). Enterococcus status at ICU admission was associated with risk for death or all-cause infection, and rectal carriage of common ICU pathogens predicted specific infections. The gastrointestinal microbiome may have a role in risk stratification and early diagnosis of ICU infections. |
X Demographics
The data shown below were collected from the profiles of 14 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 2 | 14% |
| United States | 2 | 14% |
| Australia | 1 | 7% |
| Unknown | 9 | 64% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 11 | 79% |
| Scientists | 2 | 14% |
| Science communicators (journalists, bloggers, editors) | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 167 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 167 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 32 | 19% |
| Student > Master | 18 | 11% |
| Student > Ph. D. Student | 16 | 10% |
| Student > Bachelor | 14 | 8% |
| Student > Postgraduate | 9 | 5% |
| Other | 29 | 17% |
| Unknown | 49 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 42 | 25% |
| Immunology and Microbiology | 18 | 11% |
| Biochemistry, Genetics and Molecular Biology | 12 | 7% |
| Agricultural and Biological Sciences | 9 | 5% |
| Nursing and Health Professions | 9 | 5% |
| Other | 13 | 8% |
| Unknown | 64 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 November 2019.
All research outputs
#4,599,491
of 23,577,654 outputs
Outputs from Intensive Care Medicine
#2,236
of 5,105 outputs
Outputs of similar age
#83,041
of 329,720 outputs
Outputs of similar age from Intensive Care Medicine
#88
of 142 outputs
Altmetric has tracked 23,577,654 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,105 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 28.3. This one has gotten more attention than average, scoring higher than 55% of its peers.
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We're also able to compare this research output to 142 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.