Gut mycobiome dysbiosis after sepsis and trauma

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2024年1月11日

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Gwoncheol Park,
Jennifer A. Munley,
Lauren S. Kelly,
Kolenkode B. Kannan,
Robert T. Mankowski,
Ashish Sharma,
Gilbert Upchurch,
Gemma Casadesus,
Paramita Chakrabarty,
Shannon M. Wallet,
Robert Maile,
Letitia E. Bible,
Bo Wang,
Lyle L. Moldawer,
Alicia M. Mohr,
Philip A. Efron,
Ravinder Nagpal

摘要

Background

Sepsis and trauma are known to disrupt gut bacterial microbiome communities, but the impacts and perturbations in the fungal (mycobiome) community after severe infection or injury, particularly in patients experiencing chronic critical illness (CCI), remain unstudied.

Methods

We assess persistence of the gut mycobiome perturbation (dysbiosis) in patients experiencing CCI following sepsis or trauma for up to two-to-three weeks after intensive care unit hospitalization.

Results

We show that the dysbiotic mycobiome arrays shift toward a pathobiome state, which is more susceptible to infection, in CCI patients compared to age-matched healthy subjects. The fungal community in CCI patients is largely dominated by Candida spp; while, the commensal fungal species are depleted. Additionally, these myco-pathobiome arrays correlate with alterations in micro-ecological niche involving specific gut bacteria and gut-blood metabolites.

Conclusions

The findings reveal the persistence of mycobiome dysbiosis in both sepsis and trauma settings, even up to two weeks post-sepsis and trauma, highlighting the need to assess and address the increased risk of fungal infections in CCI patients.

Graphical Abstract