Septic patients in the intensive care unit present different nasal microbiotas

Xi-Lan Tan, Hai-Yue Liu, Jun Long, Zhaofang Jiang, Yuemei Luo, Xin Zhao, Shumin Cai, Xiaozhu Zhong, Zhongran Cen, Jin Su, Hongwei Zhou, Xi-Lan Tan, Hai-Yue Liu, Jun Long, Zhaofang Jiang, Yuemei Luo, Xin Zhao, Shumin Cai, Xiaozhu Zhong, Zhongran Cen, Jin Su, Hongwei Zhou

Abstract

Aim: The primary objective of this study was to evaluate correlations among mortality, intensive care unit (ICU) length of stay and airway microbiotas in septic patients.

Materials & methods: A deep-sequencing analysis of the 16S rRNA gene V4 region was performed.

Results: The nasal microbiota in septic patients was dominated by three nasal bacterial types (Corynebacterium, Staphylococcus and Acinetobacter). The Acinetobacter type was associated with the lowest diversity and longest length of stay (median: 9 days), and the Corynebacterium type was associated with the shortest length of stay. We found that the Acinetobacter type in the >9-day group was associated with the highest mortality (33%).

Conclusion: Septic patients have three nasal microbiota types, and the nasal microbiota is related to the length of stay and mortality.

Keywords: 16S rRNA; bacterial type; microbiome; nose; sepsis.

Conflict of interest statement

Financial & competing interests disclosure

This work was supported by the National Natural Science Foundation of China (NSFC313220143 and NSFC31270152). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1. . Comparison of nasal microbiota…
Figure 1.. Comparison of nasal microbiota between septic patients and healthy subjects.
(A) α diversity between the septic patients and healthy subjects. (B) Stacked bar chart of bacteria at the genus level between the septic patients and healthy controls.  (C) Principal coordinate analysis based on unweighted UniFrac distances. The red dots represent patients with sepsis, and the blue dots represent the controls. (D) significantly different taxa between the healthy participants and septic patients were determined using the linear discriminant analysis effect size (LEfSe). The data show increasing levels of Gammaproteobacteria, Pseudomonadales, Proteobacteria, Pseudomonas, Moraxellaceae, Acinetobacter, Enterobacteriaceae and Klebsiella in the patients. (E) Machine-learning classification based on nasal microbiota using random forest algorithms. LDA: Linear discriminant analysis.
Figure 1. . Comparison of nasal microbiota…
Figure 1.. Comparison of nasal microbiota between septic patients and healthy subjects.
(A) α diversity between the septic patients and healthy subjects. (B) Stacked bar chart of bacteria at the genus level between the septic patients and healthy controls.  (C) Principal coordinate analysis based on unweighted UniFrac distances. The red dots represent patients with sepsis, and the blue dots represent the controls. (D) significantly different taxa between the healthy participants and septic patients were determined using the linear discriminant analysis effect size (LEfSe). The data show increasing levels of Gammaproteobacteria, Pseudomonadales, Proteobacteria, Pseudomonas, Moraxellaceae, Acinetobacter, Enterobacteriaceae and Klebsiella in the patients. (E) Machine-learning classification based on nasal microbiota using random forest algorithms. LDA: Linear discriminant analysis.
Figure 2. . Differences in the results…
Figure 2.. Differences in the results of the principal coordinate analysis of nasal microbiota between healthy subjects and patients with sepsis.
(A) Principal coordinate analysis (PCoA) of septic patients and healthy subjects based on unweighted UniFrac distances. (B) PCoA of healthy subjects based on unweighted UniFrac distances. (C) PCoA of patients with sepsis based on unweighted UniFrac distances. The orange circles represent the samples (nasal microbiota) with the Acinetobacter type, the purple circles represent the samples with the Corynebacterium type and the green circles represent the samples with the Staphylococcus type.
Figure 3. . Relationship between the nasal…
Figure 3.. Relationship between the nasal bacterial type in the patients with sepsis and their length of stay in the intensive care unit.
(A) Comparison of the α diversity among the three nasal bacterial types in patients with sepsis. (B) Comparison of the length of intensive care unit stay among the three nasal bacterial types in patients with sepsis. (C) Comparison of the stacked bar charts of the genera in the three nasal bacterial types in patients with sepsis. ICU: Intensive care unit; PD: Phylogenetic diversity.
Figure 4. . Relationship between the nasal…
Figure 4.. Relationship between the nasal bacterial type of patients with sepsis and the number of antibiotic use days in the intensive care unit.
Figure 5. . Mortality rates of the…
Figure 5.. Mortality rates of the three nasal bacterial types based on different lengths of intensive care unit stay.
(A) Mortality of the Corynebacterium type based on different lengths of intensive care unit (ICU) stay. (B) Mortality of the Staphylococcus type based on different lengths of ICU stay. (C) Mortality of the Acinetobacter type based on different lengths of ICU stay.

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