Abstract
BACKGROUND: Gut microbiota plays a critical role in health, with essential functions in physiology, metabolism, immunity, regulation, and protection against pathogens. Critically-ill patients admitted on the ICU experience perturbation in the microbiota, with reduction in the phylogenetic diversity and composition. Here, we aimed to investigate the rectal microbiota in patients admitted on the ICU from Colombia, focused on MDRO colonization. METHODS: Microbiome analysis and microbiological screening for MDRO and WGS were performed in rectal swabs taken on admission day from 180 patients from 5 ICUs. Microbiome analysis was determined by 16S rRNA sequencing using Illumina Miseq platform. alpha-diversity metrics were calculated by Richness, Simpson, and Shannon indexes, and beta-diversity was determined using Similarity Percentages (SIMPER) analysis. Patients were grouped into 2 cohorts: MDRO-colonized and non-colonized. Clinical data was collected using REDCap. RESULTS: MDRO colonization was detected in 13 patients (7%), and Enterobacter cloacae complex was the most prevalent microorganism (38%), followed by K. pneumoniae (23%), and P. aeruginosa (15%). Of these MDRO, 23% and 15% harbored KPC-2 and KPC-3/OXA-9 combination, respectively. Prevotella and Bacteroides were the most abundant genus in the microbiota of all patients. Interestingly, microbiota of MDRO-colonized patients showed lower diversity (Shannon p:0.0025, Simpson p: 0.0031 and richness 0.012) and had less bacterial taxa than the observed in the non-colonized group (n=167), in which Bacteroides, Porphyromonas, Campylobacter, and Oscillospiraceae genus were exclusively detected. Moreover, Parabacteroides was a genus exclusively identified in the MDRO colonized group. Further, 14 genus including Oscillospiraceae, Lactobacillus, and Faecalibacterium related to beneficial functions were lower in abundance from MDRO-colonized patients, whereas some pathobionts were present in high abundance in this group. Most of patients were men (58%); median age was 59 y/o. Charlson comorbidity index 4 (IQR=1-6). CONCLUSION: Loss in microbial diversity, with low abundance of beneficial microorganisms were associated with MDRO gut colonization in ICU patients from Colombia. DISCLOSURES: Karen Melissa Ordoñez, n/a, Pfizer: Advisor/Consultant|Pfizer: Honoraria