ArticleCritical care (London, England)2022
Oropharyngeal and intestinal concentrations of opportunistic pathogens are independently associated with death of SARS-CoV-2 critically ill adults.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Gut microbiome changes in critically ill adults: a systematic review of longitudinal sequencing studies.Critical care science · 2026Pooled it
- Gut microbiota and metabolic pathway profiles in infected and non-infected heart transplant patients before and after surgery.Scientific reports · 2026Article
- The Gut Microbiome in Sepsis: From Dysbiosis to Personalized Therapy.Journal of clinical medicine · 2024Review
- A systematic framework for understanding the microbiome in human health and disease: from basic principles to clinical translation.Signal transduction and targeted therapy · 2024Review
- Gut Microbiota Improves Prognostic Prediction in Critically Ill COVID-19 Patients Alongside Immunological and Hematological Indicators.Research (Washington, D.C.) · 2024Article
- Gut microbiota in post-acute COVID-19 syndrome: not the end of the story.Frontiers in microbiology · 2024Review
- Pathogenic Potential and Antibiotic Susceptibility: A Comprehensive Study of Enterococci from Different Ecological Settings.Pathogens (Basel, Switzerland) · 2023Article
- Altered intestinal microbiome and metabolome correspond to the clinical outcome of sepsis.Critical care (London, England) · 2023Article
- Gut microbiota composition during hospitalization is associated with 60-day mortality after severe COVID-19.Critical care (London, England) · 2023Article
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Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe composition of the digestive microbiota may be associated with outcome and infections in patients admitted to the intensive care unit (ICU). The dominance by opportunistic pathogens (such as Enterococcus) has been associated with death. However, whether this association remains all throughout the hospitalization are lacking.
methodsWe performed a single-center observational prospective cohort study in critically ill patients admitted with severe SARS-CoV-2 infection. Oropharyngeal and rectal swabs were collected at admission and then twice weekly until discharge or death. Quantitative cultures for opportunistic pathogens were performed on oropharyngeal and rectal swabs. The composition of the intestinal microbiota was assessed by 16S rDNA sequencing. Oropharyngeal and intestinal concentrations of opportunistic pathogens, intestinal richness and diversity were entered into a multivariable Cox model as time-dependent covariates. The primary outcome was death at day 90.
resultsFrom March to September 2020, 95 patients (765 samples) were included. The Simplified Acute Physiology Score 2 (SAPS 2) at admission was 33 [24; 50] and a Sequential Organ Failure Assessment score (SOFA score) at 6 [4; 8]. Day 90 all-cause mortality was 44.2% (42/95). We observed that the oropharyngeal and rectal concentrations of Enterococcus spp., Staphylococcus aureus and Candida spp. were associated with a higher risk of death. This association remained significant after adjustment for prognostic covariates (age, chronic disease, daily antimicrobial agent use and daily SOFA score). A one-log increase in Enterococcus spp., S. aureus and Candida spp. in oropharyngeal or rectal swabs was associated with a 17% or greater increase in the risk of death.
conclusionWe found that elevated oropharyngeal/intestinal Enterococcus spp. S. aureus and Candida spp. concentrations, assessed by culture, are associated with mortality, independent of age, organ failure, and antibiotic therapy, opening prospects for simple and inexpensive microbiota-based markers for the prognosis of critically ill SARS-CoV-2 patients.
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