한빛사논문
- 조회249
Vinod K. Gupta1,2†, Sanu Rajendraprasad3†, Mahmut Ozkan3, Dhanya Ramachandran4, Sumera Ahmad3, Johan S. Bakken5, Krzysztof Laudanski6, Ognjen Gajic3, Brent Bauer7, Simon Zec8, David W. Freeman9, Sahil Khanna10, Aditya Shah11, Joseph H. Skalski3, Jaeyun Sung1,2,12* and Lioudmila V. Karnatovskaia3*
1Microbiome Program, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA.
2Division of Surgery Research, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
3Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
4Department of Surgery, Mayo Clinic, Rochester, MN, USA.
5Section of Infectious Diseases, St Luke’s Hospital, Duluth, MN, USA.
6Department of Anesthesiology and Perioperative Care, Mayo Clinic, Rochester, MN, USA.
7Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
8Department of Anesthesiology and Perioperative Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
9Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA.
10Division of Gastroenterology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
11Division of Public Health, Infectious Diseases, and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
12Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
†Vinod K. Gupta and Sanu Rajendraprasad contributed equally to this work.
*Correspondence: Jaeyun Sung, Lioudmila V. Karnatovskaia
Abstract
Background: Dysbiosis of the gut microbiome is frequent in the intensive care unit (ICU), potentially leading to a heightened risk of nosocomial infections. Enhancing the gut microbiome has been proposed as a strategic approach to mitigate potential adverse outcomes. While prior research on select probiotic supplements has not successfully shown to improve gut microbial diversity, fermented foods offer a promising alternative. In this open-label phase I safety and feasibility study, we examined the safety and feasibility of kefir as an initial step towards utilizing fermented foods to mitigate gut dysbiosis in critically ill patients.
Methods: We administered kefir in escalating doses (60 mL, followed by 120 mL after 12 h, then 240 mL daily) to 54 critically ill patients with an intact gastrointestinal tract. To evaluate kefir's safety, we monitored for gastrointestinal symptoms. Feasibility was determined by whether patients received a minimum of 75% of their assigned kefir doses. To assess changes in the gut microbiome composition following kefir administration, we collected two stool samples from 13 patients: one within 72 h of admission to the ICU and another at least 72 h after the first stool sample.
Results: After administering kefir, none of the 54 critically ill patients exhibited signs of kefir-related bacteremia. No side effects like bloating, vomiting, or aspiration were noted, except for diarrhea in two patients concurrently on laxatives. Out of the 393 kefir doses prescribed for all participants, 359 (91%) were successfully administered. We were able to collect an initial stool sample from 29 (54%) patients and a follow-up sample from 13 (24%) patients. Analysis of the 26 paired samples revealed no increase in gut microbial α-diversity between the two timepoints. However, there was a significant improvement in the Gut Microbiome Wellness Index (GMWI) by the second timepoint (P = 0.034, one-sided Wilcoxon signed-rank test); this finding supports our hypothesis that kefir administration can improve gut health in critically ill patients. Additionally, the known microbial species in kefir were found to exhibit varying levels of engraftment in patients' guts.
Conclusions: Providing kefir to critically ill individuals is safe and feasible. Our findings warrant a larger evaluation of kefir's safety, tolerability, and impact on gut microbiome dysbiosis in patients admitted to the ICU.
논문정보
- Research article
- 2024년 02월 (BRIC 등록일 2024-03-06)
- 국외 연구진
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