Microbiome

🦠 Microbiome – The Hidden World Inside Us

The **microbiome** consists of **all living microbes** residing in the **host’s gut, skin, mouth, and lungs**.

The **human gut alone** houses:

  • 🔬 **40 trillion microorganisms**.
  • 🦠 **1,000 different bacterial taxa**.
  • 🧬 **100-fold more genes** than the human genome.

⚠️ What Happens After Taking Antibiotics?

**A study in ICU patients** revealed that a **single bacterial genus** can make up **more than 50% of gut microbiota** post-antibiotics.

Within **6 hours of ICU admission and antibiotic administration**, **dysbiosis** (microbial imbalance) begins, leading to:

  • ❌ **Impaired host immune response**.
  • ❌ **Increased susceptibility to nosocomial infections**.
Friday ID Day

🦠 Can We Restore Gut Microbiota?

**Probiotics, prebiotics, and synbiotics** (a combination of **probiotics & prebiotics**) are given to **promote beneficial bacteria**.

📊 Evidence from Meta-Analysis

Meta-analyses have shown **no mortality benefit** from probiotics. However, they do show **some benefits** in:

  • 📉 **Reducing length of hospital stay (LOS)**.
  • 🛡️ **Lowering incidence of ventilator-associated pneumonia (VAP)**.
  • 💨 **Decreasing mechanical ventilation needs** (in some RCTs).

💩 Fecal Microbiota Transplant (FMT) – A Revolutionary Approach

**FMT (Fecal Microbiota Transplant)** is the **transfer of intestinal microorganisms** from a **healthy donor** to a patient using an **infusion of liquid stool suspension**.

FMT aims to **restore the normal gut microenvironment** in individuals with **altered microbiota**.

🧪 FMT vs. Vancomycin for Clostridium difficile

**Multiple meta-analyses** have shown that **FMT is superior to Vancomycin** in resolving **Clostridium difficile infections**.

🚨 However, **FMT attempts in other ICU infections have not yet been fully successful**.

🔬 The Role of Microbiome in Tackling AMR (Antimicrobial Resistance)

**Microbiome-based approaches** are a **futuristic strategy** to **combat antimicrobial resistance (AMR)**.

📢 Key Takeaways

  • ✔️ **Dysbiosis occurs rapidly after antibiotic use in ICU settings**.
  • ✔️ **Probiotics may help but do not reduce mortality**.
  • ✔️ **FMT is highly effective for Clostridium difficile infections**.
  • ✔️ **More research is needed for FMT use in ICU settings**.

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