caa a22 4500 445795840 CHVBK 20180317145124.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10620-010-1418-8 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1418-8 Altered Gut Flora Are Associated with Septic Complications and Death in Critically Ill Patients with Systemic Inflammatory Response Syndrome [Elektronische Daten] [Kentaro Shimizu, Hiroshi Ogura, Toshimitsu Hamasaki, Miki Goto, Osamu Tasaki, Takashi Asahara, Koji Nomoto, Masami Morotomi, Asako Matsushima, Yasuyuki Kuwagata, Hisashi Sugimoto] Background: Gut under severe insult is considered to have an important role in promoting infection and multiple organ dysfunction syndrome from the viewpoint of altered intestinal epithelium, immune system and commensal bacteria. There are few reports, however, about the relationship between gut flora and septic complications. Methods: We analyzed gut flora in patients with systemic inflammatory response syndrome (SIRS) and evaluated key bacteria and their cutoff values for infectious complications and mortality by using classification and regression trees (CART). Eighty-one SIRS patients with a serum C-reactive protein level higher than 10mg/dL treated in the intensive care unit (ICU) for more than 2days were included for the study. We quantitatively evaluated nine types of bacteria in fecal samples by plate or tube technique. Two hundred seventy-one samples were analyzed using CART and logistic regression. Results: The dominant factors for complication of enteritis were the minimum number of total obligate anaerobes and the maximum number of Staphylococcus and Enterococcus. The dominant factors for complication of bacteremia were the minimum numbers of total obligate anaerobes and total facultative anaerobes. The dominant factors for mortality were the numbers of total obligate anaerobes and total facultative anaerobes and age. Conclusions: A decrease in total obligate anaerobes and an increase in pathogenic bacteria in the gut are associated with septic complications and mortality in patients with SIRS. The altered gut flora may be a potential prognostic marker in SIRS patients. The Author(s), 2010 Gut nationallicence Flora nationallicence Probiotics nationallicence Sepsis nationallicence Classification and regression trees nationallicence ICU nationallicence Shimizu Kentaro Department of Clinical Quality Management, Osaka University Hospital, Osaka, Japan aut Ogura Hiroshi Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut Hamasaki Toshimitsu Department of Biomedical Statistics, Osaka University Graduate School of Medicine, Osaka, Japan aut Goto Miki Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut Tasaki Osamu Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut Asahara Takashi Yakult Central Institute for Microbiological Research, Tokyo, Japan aut Nomoto Koji Yakult Central Institute for Microbiological Research, Tokyo, Japan aut Morotomi Masami Yakult Central Institute for Microbiological Research, Tokyo, Japan aut Matsushima Asako Department of Trauma and Critical Care Medicine, Social Insurance Chukyo Hospital, Nagoya, Aichi, Japan aut Kuwagata Yasuyuki Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut Sugimoto Hisashi Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka, Japan aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1171-1177 0163-2116 56:4<1171 2011 56 10620 https://doi.org/10.1007/s10620-010-1418-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1418-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shimizu Kentaro Department of Clinical Quality Management, Osaka University Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Ogura Hiroshi Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut NATIONALLICENCE 700 1- Hamasaki Toshimitsu Department of Biomedical Statistics, Osaka University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Goto Miki Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut NATIONALLICENCE 700 1- Tasaki Osamu Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut NATIONALLICENCE 700 1- Asahara Takashi Yakult Central Institute for Microbiological Research, Tokyo, Japan aut NATIONALLICENCE 700 1- Nomoto Koji Yakult Central Institute for Microbiological Research, Tokyo, Japan aut NATIONALLICENCE 700 1- Morotomi Masami Yakult Central Institute for Microbiological Research, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsushima Asako Department of Trauma and Critical Care Medicine, Social Insurance Chukyo Hospital, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Kuwagata Yasuyuki Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, 565-0871, Suita-city, Osaka, Japan aut NATIONALLICENCE 700 1- Sugimoto Hisashi Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka, Japan aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1171-1177 0163-2116 56:4<1171 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer