Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study

Abstract Background The gut and lung microbiomes play crucial roles in host defense and mayserve as predictive markersfor clinical outcomes in critically ill patients. Despite this, the simultaneous dynamics of lung and gut microbiomes during critical illness remain unclear. This study aims to asses...

Full description

Saved in:
Bibliographic Details
Main Authors: Antonios Kritikos, Eric Bernasconi, Yangji Choi, Valentin Scherz, Jean-Luc Pagani, Gilbert Greub, Claire Bertelli, Benoit Guery
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-025-10825-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850268631075651584
author Antonios Kritikos
Eric Bernasconi
Yangji Choi
Valentin Scherz
Jean-Luc Pagani
Gilbert Greub
Claire Bertelli
Benoit Guery
author_facet Antonios Kritikos
Eric Bernasconi
Yangji Choi
Valentin Scherz
Jean-Luc Pagani
Gilbert Greub
Claire Bertelli
Benoit Guery
author_sort Antonios Kritikos
collection DOAJ
description Abstract Background The gut and lung microbiomes play crucial roles in host defense and mayserve as predictive markersfor clinical outcomes in critically ill patients. Despite this, the simultaneous dynamics of lung and gut microbiomes during critical illness remain unclear. This study aims to assess the longitudinal changes in lung and gut microbiota among mechanically ventilated ICU patients with and without infection and to identify microbial features predictive of clinical outcomes, including the development of ventilator associated pneumonia (VAP). Methods In this prospective observational study, we analyzed 73 endotracheal aspirates (ETA) and 93 rectal swabs collected from 38 ICU patients over multiple timepoints (intubation, infection onset, post-antibiotic, and extubation/discharge). Patients were categorized into three groups: (1) VAP, (2) other infections, and (3) uninfected controls. Lung and gut microbiota were characterized using 16S rRNA gene sequencing. Primary outcomes included microbial diversity and community composition; secondary outcomes included ICU length of stay and ventilator-free days. Results Alpha diversity declined more significantly in infected patients than in controls during the ICU stay, with the most pronounced changes in lung microbiota. We found an enrichment of Enterobacteriaceae and other Proteobacteria in the lung microbiome of pneumonia patients, while the gut microbiota remained relatively stable. Relative abundances of key taxa such as Mogibacterium were associated with mechanical ventilation duration. Conclusions This study reveals that distinct microbial patterns in both lung and gut microbiota are associated with infection and clinical outcomes in critically ill patients. Understanding these dynamics is crucial for developing targeted microbiota interventions, potentially improving outcomes such as VAP prevention and management. Trial registration Ethics Committee of Canton Vaud, Switzerland (2017–01820).
format Article
id doaj-art-94e9a113681b4d51a6b507c870b8fa88
institution OA Journals
issn 1471-2334
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series BMC Infectious Diseases
spelling doaj-art-94e9a113681b4d51a6b507c870b8fa882025-08-20T01:53:23ZengBMCBMC Infectious Diseases1471-23342025-04-0125111510.1186/s12879-025-10825-6Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot studyAntonios Kritikos0Eric Bernasconi1Yangji Choi2Valentin Scherz3Jean-Luc Pagani4Gilbert Greub5Claire Bertelli6Benoit Guery7Institute of Microbiology, Lausanne University Hospital and University of LausanneDepartment of Respiratory Medicine, Lausanne University Hospital and University of LausanneInstitute of Microbiology, Lausanne University Hospital and University of LausanneInstitute of Microbiology, Lausanne University Hospital and University of LausanneIntensive Care Unit, Lausanne University Hospital and University of LausanneInstitute of Microbiology, Lausanne University Hospital and University of LausanneInstitute of Microbiology, Lausanne University Hospital and University of LausanneService of Infectious Diseases, Lausanne University Hospital and University of LausanneAbstract Background The gut and lung microbiomes play crucial roles in host defense and mayserve as predictive markersfor clinical outcomes in critically ill patients. Despite this, the simultaneous dynamics of lung and gut microbiomes during critical illness remain unclear. This study aims to assess the longitudinal changes in lung and gut microbiota among mechanically ventilated ICU patients with and without infection and to identify microbial features predictive of clinical outcomes, including the development of ventilator associated pneumonia (VAP). Methods In this prospective observational study, we analyzed 73 endotracheal aspirates (ETA) and 93 rectal swabs collected from 38 ICU patients over multiple timepoints (intubation, infection onset, post-antibiotic, and extubation/discharge). Patients were categorized into three groups: (1) VAP, (2) other infections, and (3) uninfected controls. Lung and gut microbiota were characterized using 16S rRNA gene sequencing. Primary outcomes included microbial diversity and community composition; secondary outcomes included ICU length of stay and ventilator-free days. Results Alpha diversity declined more significantly in infected patients than in controls during the ICU stay, with the most pronounced changes in lung microbiota. We found an enrichment of Enterobacteriaceae and other Proteobacteria in the lung microbiome of pneumonia patients, while the gut microbiota remained relatively stable. Relative abundances of key taxa such as Mogibacterium were associated with mechanical ventilation duration. Conclusions This study reveals that distinct microbial patterns in both lung and gut microbiota are associated with infection and clinical outcomes in critically ill patients. Understanding these dynamics is crucial for developing targeted microbiota interventions, potentially improving outcomes such as VAP prevention and management. Trial registration Ethics Committee of Canton Vaud, Switzerland (2017–01820).https://doi.org/10.1186/s12879-025-10825-6Gut microbiotaLung microbiotaGut-lung axisIntensive care unitVentilation acquired pneumoniaDysbiosis
spellingShingle Antonios Kritikos
Eric Bernasconi
Yangji Choi
Valentin Scherz
Jean-Luc Pagani
Gilbert Greub
Claire Bertelli
Benoit Guery
Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
BMC Infectious Diseases
Gut microbiota
Lung microbiota
Gut-lung axis
Intensive care unit
Ventilation acquired pneumonia
Dysbiosis
title Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
title_full Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
title_fullStr Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
title_full_unstemmed Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
title_short Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study
title_sort lung and gut microbiota profiling in intensive care unit patients a prospective pilot study
topic Gut microbiota
Lung microbiota
Gut-lung axis
Intensive care unit
Ventilation acquired pneumonia
Dysbiosis
url https://doi.org/10.1186/s12879-025-10825-6
work_keys_str_mv AT antonioskritikos lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT ericbernasconi lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT yangjichoi lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT valentinscherz lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT jeanlucpagani lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT gilbertgreub lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT clairebertelli lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy
AT benoitguery lungandgutmicrobiotaprofilinginintensivecareunitpatientsaprospectivepilotstudy