Evidence map›Paper›PMID 29766103›Full record

ArticleTrauma surgery & acute care open2017

Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury.

Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mary F Nelson, Eric M Campion, Rachael A Callcut, Carolyn S Calfee, Brandon J Lamere, Douglas W Fadrosh and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  6. Macrophages on demand: How tissue trauma shapes their role.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Benjamin M HowardDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Lucy Z KornblithDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Sabrinah A ChristieDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Amanda S ConroyDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Mary F NelsonDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Eric M CampionDepartment of Surgery, Denver Health and Hospital Authority, University of Colorado, Denver, Colorado, USA.
Rachael A CallcutDepartment of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA.
Carolyn S CalfeeDivision of Pulmonary and Critical Care Medicine, Departments of Medicine and Anesthesia, University of California San Francisco, California, USA.
Brandon J LamereDivision of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA.
Douglas W FadroshDivision of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA.
Susan LynchDivision of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA.
Mitchell Jay CohenDepartment of Surgery, Denver Health and Hospital Authority, University of Colorado, Denver, Colorado, USA.

Funding

Advancing Outcome Metrics in Trauma Surgery Through Utilization of Big DataK01ES026834 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALLCUT, RACHAEL A · 2015 to 2018
$889k
NIEHS NIH HHS K01 ES026834
6 · The paper itself

Abstract

backgroundRecent studies have demonstrated the vital influence of commensal microbial communities on human health. The central role of the gut in the response to injury is well described; however, no prior studies have used culture-independent profiling techniques to characterize the gut microbiome after severe trauma. We hypothesized that in critically injured patients, the gut microbiome would undergo significant compositional changes in the first 72 hours after injury.

methodsTrauma stool samples were prospectively collected via digital rectal examination at the time of presentation (0 hour). Patients admitted to the intensive care unit (n=12) had additional stool samples collected at 24 hours and/or 72 hours. Uninjured patients served as controls (n=10). DNA was extracted from stool samples and 16S rRNA-targeted PCR amplification was performed; amplicons were sequenced and binned into operational taxonomic units (OTUs; 97% sequence similarity). Diversity was analyzed using principle coordinates analyses, and negative binomial regression was used to determine significantly enriched OTUs.

resultsCritically injured patients had a median Injury Severity Score of 27 and suffered polytrauma. At baseline (0 hour), there were no detectable differences in gut microbial community diversity between injured and uninjured patients. Injured patients developed changes in gut microbiome composition within 72 hours, characterized by significant alterations in phylogenetic composition and taxon relative abundance. Members of the bacterial orders Bacteroidales, Fusobacteriales and Verrucomicrobiales were depleted during 72 hours, whereas Clostridiales and Enterococcus members enriched significantly. DISCUSSION: In this initial study of the gut microbiome after trauma, we demonstrate that significant changes in phylogenetic composition and relative abundance occur in the first 72 hours after injury. This rapid change in intestinal microbiota represents a critical phenomenon that may influence outcomes after severe trauma. A better understanding of the nature of these postinjury changes may lead to the ability to intervene in otherwise pathological clinical trajectories. LEVEL OF EVIDENCE: III. STUDY TYPE: Prognostic/epidemiological.

Indexed as

critical illnessinflammatory responsemicrobiometrauma and sepsis

Identifiers

PMID29766103
PMCPMC5877916

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.