Significant changes in the balance and make-up of gut bacteria occur within 72 hours of serious injury/trauma, according to a study published yesterday in Trauma Surgery & Acute Care Open.
These changes may influence the chances of recovery or death, and might enable doctors to stave off critical illness, suggest the study authors from San Francisco General Hospital, University of California San Francisco.
The gut has a key role in responding to injury, and the composition of the microbiome has been linked to various aspects of human health. However, according to the authors, no prior studies used culture-independent profiling techniques to characterize the gut microbiome after serious trauma previously.
The study examined the numbers and types of bacteria in the stool samples of 12 critically injured patients. The samples were collected on admission, and then again 24 and 72 hours later. These were compared with stool samples taken from 10 patients treated at the same trauma center, but who had not been seriously injured and who didn't require intensive care.
The first of the samples taken showed comparable numbers and types of gut bacteria in the two groups of patients, but substantial differences began to emerge by the time the second sample was taken. After 72 hours, the samples showed that bacteroidetes, fusobacteria, and verruccomicrobiaceae bacteria were all depleted, whereas clostridia and enterococci species had all increased.
"The short time course in which such alterations occur is also notable—such relatively rapid alterations in intestinal microbiota represent a critical and previously unrecognized phenomenon that may influence clinical course and outcomes after severe trauma," explain the authors.
"Implementing a probiotic regimen or guiding the microbial composition changes after trauma might prove a powerful tool in the critical care arsenal...Though causal relationships remain to be determined, a better understanding of the nature of these post injury changes may lead to the ability to intervene in otherwise pathological clinical trajectories," they add.