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Abstract

The study of gut microbiota is now an essential dimension in many clinical studies. For instance, microbiota diversity investigation can help us to better manage cirrhotic patients by the identification of markers of severity and the identification of possible sources of pathogens.

Conducting clinical research on gut microbiota for fragile patients in intensive care units, such as cirrhotic patients, poses significant challenges.

In this study, we developed a comprehensive toolkit for investigating gut microbiota in fragile patients using rectal swabbing combined with straightforward lifestyle and clinical questionnaires.

We applied this prospective approach to 49 well-phenotyped cirrhotic patients as a function of their compensation status (compensated patients with outpatients’ recruitment vs decompensated patients in intensive care units).

Our results, consistent with the literature, showed that liver function impairment is associated with lower microbiota diversity. Additionally, we monitored aerobic microbiota in decompensated cirrhotic patients, observing the invasion of extended spectrum beta-lactamase (ESBL)-producing in the gut’s aerobic microbiota prior to severe infection caused by these pathogens.

We propose this pragmatic methodology for larger cohort studies, aiming to enhance the monitoring of immunocompromised patients by using microbiota analysis as a predictive tool for the severity of associated pathologies and the identification of agents responsible for severe infections.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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/content/journal/jmm/10.1099/jmm.0.001964
2025-03-06
2026-01-19

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References

  1. Tapper EB, Parikh ND. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ 2018; 362:k2817 [View Article] [PubMed]
    [Google Scholar]
  2. Pimpin L, Cortez-Pinto H, Negro F, Corbould E, Lazarus JV et al. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies. J Hepatol 2018; 69:718–735 [View Article] [PubMed]
    [Google Scholar]
  3. Trebicka J, Macnaughtan J, Schnabl B, Shawcross DL, Bajaj JS. The microbiota in cirrhosis and its role in hepatic decompensation. J Hepatol 2021; 75 Suppl 1:S67–S81 [View Article] [PubMed]
    [Google Scholar]
  4. Kim YS, Unno T, Kim B-Y, Park M-S. Sex Differences in Gut Microbiota. World J Mens Health 2020; 38:48–60 [View Article] [PubMed]
    [Google Scholar]
  5. Spor A, Koren O, Ley R. Unravelling the effects of the environment and host genotype on the gut microbiome. Nat Rev Microbiol 2011; 9:279–290 [View Article] [PubMed]
    [Google Scholar]
  6. Dethlefsen L, Relman DA. Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proc Natl Acad Sci USA 2011; 108 Suppl 1:4554–4561 [View Article] [PubMed]
    [Google Scholar]
  7. De Filippo C, Cavalieri D, Di Paola M, Ramazzotti M, Poullet JB et al. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci USA 2010; 107:14691–14696 [View Article] [PubMed]
    [Google Scholar]
  8. Nagpal R, Tsuji H, Takahashi T, Nomoto K, Kawashima K et al. Ontogenesis of the gut microbiota composition in healthy, full-term, vaginally born and breast-fed infants over the first 3 years of life: a quantitative bird’s-eye view. Front Microbiol 2017; 8:1388 [View Article] [PubMed]
    [Google Scholar]
  9. Odamaki T, Kato K, Sugahara H, Hashikura N, Takahashi S et al. Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study. BMC Microbiol 2016; 16:90 [View Article] [PubMed]
    [Google Scholar]
  10. Clarke SF, Murphy EF, O’Sullivan O, Lucey AJ, Humphreys M et al. Exercise and associated dietary extremes impact on gut microbial diversity. Gut 2014; 63:1913–1920 [View Article] [PubMed]
    [Google Scholar]
  11. Xu M, Wang B, Fu Y, Chen Y, Yang F et al. Changes of fecal Bifidobacterium species in adult patients with hepatitis B virus-induced chronic liver disease. Microb Ecol 2012; 63:304–313 [View Article] [PubMed]
    [Google Scholar]
  12. Tremaroli V, Bäckhed F. Functional interactions between the gut microbiota and host metabolism. Nature 2012; 489:242–249 [View Article] [PubMed]
    [Google Scholar]
  13. Purchiaroni F, Tortora A, Gabrielli M, Bertucci F, Gigante G et al. The role of intestinal microbiota and the immune system. Eur Rev Med Pharmacol Sci 2013; 17:323–333 [PubMed]
    [Google Scholar]
  14. Liu J, Wu D, Ahmed A, Li X, Ma Y et al. Comparison of the gut microbe profiles and numbers between patients with liver cirrhosis and healthy individuals. Curr Microbiol 2012; 65:7–13 [View Article] [PubMed]
    [Google Scholar]
  15. Zhang L, Foxman B, Marrs C. Both urinary and rectal Escherichia coli isolates are dominated by strains of phylogenetic group B2. J Clin Microbiol 2002; 40:3951–3955 [View Article] [PubMed]
    [Google Scholar]
  16. Ruppé E, Lixandru B, Cojocaru R, Büke C, Paramythiotou E et al. Relative fecal abundance of extended-spectrum-β-lactamase-producing Escherichia coli strains and their occurrence in urinary tract infections in women. Antimicrob Agents Chemother 2013; 57:4512–4517 [View Article] [PubMed]
    [Google Scholar]
  17. Nahon P, Lescat M, Layese R, Bourcier V, Talmat N et al. Bacterial infection in compensated viral cirrhosis impairs 5-year survival (ANRS CO12 CirVir prospective cohort). Gut 2017; 66:330–341 [View Article] [PubMed]
    [Google Scholar]
  18. Lefort A, Panhard X, Clermont O, Woerther P-L, Branger C et al. Host factors and portal of entry outweigh bacterial determinants to predict the severity of Escherichia coli bacteremia. J Clin Microbiol 2011; 49:777–783 [View Article] [PubMed]
    [Google Scholar]
  19. Lee NY, Suk KT. The role of the gut microbiome in liver cirrhosis treatment. Int J Mol Sci 2020; 22:199 [View Article] [PubMed]
    [Google Scholar]
  20. Marin J, Bertoye PA, Birgy A, Dziri S, Lescat M. Validation of rectal swabbing for total and aerobic gut microbiota study. medRxiv 2024 [View Article]
    [Google Scholar]
  21. Labbe E, Blanquet M, Gerbaud L, Poirier G, Sass C et al. A new reliable index to measure individual deprivation: the EPICES score. Eur J Public Health 2015; 25:604–609 [View Article] [PubMed]
    [Google Scholar]
  22. Hercberg S, Chat-Yung S, Chaulia M. The French National Nutrition and Health Program: 2001-2006-2010. Int J Public Health 2008; 53:68–77 [View Article] [PubMed]
    [Google Scholar]
  23. Chaltiel D, Julia C, Adjibade M, Touvier M, Hercberg S et al. Adherence to the 2017 French dietary guidelines and adult weight gain: a cohort study. PLoS Med 2019; 16:e1003007 [View Article] [PubMed]
    [Google Scholar]
  24. Haute Autorité de Santé Antibiothérapie des infections à entérobactéries et à pseudomonas aeruginosa chez l’adulte: place des carbapénèmes et de leurs alternatives; 2019
  25. Champely S, Dalgaard P, Gill J, Weibelzahl S, Anandkumar A et al.Package ‘pwr 2022
  26. S, Josse J, Husson F. FactoMineR: an R package for multivariate analysis. J Stat Softw 2008; 25:1–18 [View Article]
    [Google Scholar]
  27. Shao L, Ling Z, Chen D, Liu Y, Yang F et al. Disorganized gut microbiome contributed to liver cirrhosis progression: a meta-omics-based study. Front Microbiol 2018; 9:3166 [View Article] [PubMed]
    [Google Scholar]
  28. Trebicka J, Fernandez J, Papp M, Caraceni P, Laleman W et al. PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis. J Hepatol 2021; 74:1097–1108 [View Article]
    [Google Scholar]
  29. Prado V, Hernández-Tejero M, Mücke MM, Marco F, Gu W et al. Rectal colonization by resistant bacteria increases the risk of infection by the colonizing strain in critically ill patients with cirrhosis. J Hepatol 2022; 76:1079–1089 [View Article] [PubMed]
    [Google Scholar]
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