Evidence map›Paper›PMID 30526610›Full record

Observational studyRespiratory research2018

Microbial dysbiosis and mortality during mechanical ventilation: a prospective observational study.

Daphnée Lamarche, Jennie Johnstone, Nicole Zytaruk, France Clarke, Lori Hand, Dessi Loukov, Jake C Szamosi, Laura Rossi, Louis P Schenck, Chris P Verschoor and 11 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Respiratory research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01782755 (Probiotics), which is not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing 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.

NCT01782755 phase2completednot on this map

Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial (PROSPECT): A Feasibility Clinical Trial

TypeinterventionalSponsorMcMaster UniversityRan2013 to 2015Enrolled150ConditionsVentilator Associated Pneumonia (VAP), Other Infections, Antibiotic-Associated Diarrhea, C-DifficileArmsL. rhamnosus GG - Probiotic, Placebo - Microcrystalline Cellulose
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Review
  8. Article
  9. Article
  10. The gastrointestinal microbiome in critical illness: A Clinician's guide to mechanisms, emerging tools, and therapeutic questions.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025
    Review
  11. Article
  12. Article
  13. Observational
  14. High-resolution plasma metabolomics and thiamine status in critically Ill adult patients.Metabolomics : Official journal of the Metabolomic Society · 2024
    Article
  15. Article
  16. Observational
  17. Review
  18. Observational
  19. Article
  20. Observational
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

21 authors.

Daphnée LamarcheDepartment of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
Jennie JohnstoneDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Nicole ZytarukSt. Joseph's Healthcare, Hamilton, ON, Canada.
France ClarkeSt. Joseph's Healthcare, Hamilton, ON, Canada.
Lori HandDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Dessi LoukovInstitute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.
Jake C SzamosiInstitute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.
Laura RossiDepartment of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
Louis P SchenckDepartment of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
Chris P VerschoorDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Ellen McDonaldDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Maureen O MeadeDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
John C MarshallDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Dawn M E BowdishInstitute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.
Tim KarachiHamilton Health Sciences, Hamilton, ON, Canada.
Diane Heels-AnsdellDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Deborah J CookSt. Joseph's Healthcare, Hamilton, ON, Canada.
Michael G SuretteDepartment of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada. Surette@mcmaster.ca.
PROSPECT Investigators
Canadian Critical Care Trials Group
Canadian Critical Care Translational Biology Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHost-associated microbial communities have important roles in tissue homeostasis and overall health. Severe perturbations can occur within these microbial communities during critical illness due to underlying diseases and clinical interventions, potentially influencing patient outcomes. We sought to profile the microbial composition of critically ill mechanically ventilated patients, and to determine whether microbial diversity is associated with illness severity and mortality.

methodsWe conducted a prospective, observational study of mechanically ventilated critically ill patients with a high incidence of pneumonia in 2 intensive care units (ICUs) in Hamilton, Canada, nested within a randomized trial for the prevention of healthcare-associated infections. The microbial profiles of specimens from 3 anatomical sites (respiratory, and upper and lower gastrointestinal tracts) were characterized using 16S ribosomal RNA gene sequencing.

resultsWe collected 65 specimens from 34 ICU patients enrolled in the trial (29 endotracheal aspirates, 26 gastric aspirates and 10 stool specimens). Specimens were collected at a median time of 3 days (lower respiratory tract and gastric aspirates; interquartile range [IQR] 2-4) and 6 days (stool; IQR 4.25-6.75) following ICU admission. We observed a loss of biogeographical distinction between the lower respiratory tract and gastrointestinal tract microbiota during critical illness. Moreover, microbial diversity in the respiratory tract was inversely correlated with APACHE II score (r = - 0.46, p = 0.013) and was associated with hospital mortality (Median Shannon index: Discharged alive; 1.964 vs. Deceased; 1.348, p = 0.045).

conclusionsThe composition of the host-associated microbial communities is severely perturbed during critical illness. Reduced microbial diversity reflects high illness severity and is associated with mortality. Microbial diversity may be a biomarker of prognostic value in mechanically ventilated patients.

trial registrationClinicalTrials.gov ID NCT01782755 . Registered February 4 2013.

Indexed as

DysbiosisMicrobiological PhenomenaRespiration, ArtificialAgedCritical IllnessFemaleHumansIntensive Care UnitsMaleMiddle AgedPilot ProjectsProspective StudiesCritical illnessGastrointestinal tract microbiotaMicrobial diversityMicrobiomeRespiratory tract microbiota

Identifiers

PMID30526610
PMCPMC6286574

What OpenQuestion holds

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Registered trials

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.