Oropharyngeal and intestinal concentrations of opportunistic pathogens are independentlyassociated with death of SARS-CoV-2 critically ill adults
In: ISSN: 1364-8535, 2022
Online
academicJournal
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International audience ; Background The composition of the digestive microbiota may be associated with outcome and infections in patients admitted to the intensive care unit (ICU). The dominance by opportunistic pathogens (such as Enterococcus ) has been associated with death. However, whether this association remains all throughout the hospitalization are lacking. Methods We performed a single-center observational prospective cohort study in critically ill patients admitted with severe SARS-CoV-2 infection. Oropharyngeal and rectal swabs were collected at admission and then twice weekly until discharge or death. Quantitative cultures for opportunistic pathogens were performed on oropharyngeal and rectal swabs. The composition of the intestinal microbiota was assessed by 16S rDNA sequencing. Oropharyngeal and intestinal concentrations of opportunistic pathogens, intestinal richness and diversity were entered into a multivariable Cox model as time-dependent covariates. The primary outcome was death at day 90. Results From March to September 2020, 95 patients (765 samples) were included. The Simplified Acute Physiology Score 2 ( SAPS 2) at admission was 33 [24; 50] and a Sequential Organ Failure Assessment score (SOFA score) at 6 [4; 8]. Day 90 all-cause mortality was 44.2% (42/95). We observed that the oropharyngeal and rectal concentrations of Enterococcus spp., Staphylococcus aureus and Candida spp. were associated with a higher risk of death. This association remained significant after adjustment for prognostic covariates (age, chronic disease, daily antimicrobial agent use and daily SOFA score). A one-log increase in Enterococcus spp . , S. aureus and Candida spp. in oropharyngeal or rectal swabs was associated with a 17% or greater increase in the risk of death. Conclusion We found that elevated oropharyngeal/intestinal Enterococcus spp. S. aureus and Candida spp. concentrations, assessed by culture, are associated with mortality, independent of age, organ failure, and antibiotic therapy, opening prospects ...
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Oropharyngeal and intestinal concentrations of opportunistic pathogens are independentlyassociated with death of SARS-CoV-2 critically ill adults
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| Autor/in / Beteiligte Person: | Patrier, Juliette ; Villageois-Tran, Khanh ; Szychowiak, Piotr ; Ruckly, Stéphane ; Gschwind, Rémi ; Wicky, Paul-Henri ; Gueye, Signara ; Armand-Lefevre, Laurence ; Marzouk, Mehdi ; Sonneville, Romain ; Bouadma, Lila ; Petitjean, Marie ; Lamara, Fariza ; de Montmollin, Etienne ; Timsit, Jean-Francois ; Ruppé, Etienne ; Abel, Laurent ; Abrous, Amal ; Andrejak, Claire ; Angoulvant, François ; Bachelet, Delphine ; Bartoli, Marie ; Behilill, Sylvie ; Beluze, Marine ; Bhavsar, Krishna ; Cervantes-Gonzalez, Minerva ; Chair, Anissa ; Charpentier, Charlotte ; Chenard, Léo ; Chirouze, Catherine ; Couffin-Cadiergues, Sandrine ; Couffignal, Camille ; Debray, Marie-Pierre ; Deplanque, Dominique ; Descamps, Diane ; Diallo, Alpha ; da Silva, Fernanda Dias ; Dorival, Céline ; Duval, Xavier ; Eloy, Philippine ; Enouf, Vincent ; Esperou, Hélène ; Esposito-Farese, Marina ; Etienne, Manuel ; Florence, Aline-Marie ; Gaymard, Alexandre ; Ghosn, Jade ; Gigante, Tristan ; Gilg, Morgane ; Goehringer, François ; Guedj, Jérémie ; Houas, Ikram ; Hoffmann, Isabelle ; Hulot, Jean-Sébastien ; Jaafoura, Salma ; Kafif, Ouifiya ; Khalil, Antoine ; Lafhej, Nadhem ; Laouénan, Cédric ; Laribi, Samira ; Le, Minh ; Le Hingrat, Quentin ; Le Mestre, Soizic ; Letrou, Sophie ; Levy, Yves ; Lina, Bruno ; Lingas, Guillaume ; Malvy, Denis ; Mentré, France ; Mouquet, Hugo ; Neant, Nadège ; Paul, Christelle ; Papadopoulos, Aurélie ; Petrov-Sanchez, Ventzislava ; Peytavin, Gilles ; Piquard, Valentine ; Picone, Olivier ; Rosa-Calatrava, Manuel ; Rossignol, Bénédicte ; Rossignol, Patrick ; Roy, Carine ; Schneider, Marion ; Su, Richa ; Tardivon, Coralie ; Timsit, Jean-François ; Tubiana, Sarah ; van der Werf, Sylvie ; Visseaux, Benoit ; Wiedemann, Aurélie ; AP-HP - Hôpital Bichat - Claude Bernard Paris ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) ; CHU Saint-Antoine AP-HP ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) ; CHU Trousseau Tours ; Centre Hospitalier Régional Universitaire de Tours (CHRU Tours) ; Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord ; Physiopathologie et pharmacotoxicologie placentaire humaine : Microbiote pré & post natal (3PHM - UMR-S 1139) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité) ; Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163) ; Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)) ; École Pratique des Hautes Études (EPHE) ; Université Paris Sciences et Lettres (PSL)-Université Paris Sciences et Lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité) ; Health data- and model- driven Knowledge Acquisition (HeKA) ; Inria de Paris ; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)) ; Université Paris Sciences et Lettres (PSL)-Université Paris Sciences et Lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE) ; Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)) ; Institut Pasteur Paris (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité) ; Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae Paris (CNR - laboratoire coordonnateur) ; Institut Pasteur Paris (IP)-Université Paris Cité (UPCité) ; This work was partially supported by the Direction Générale des Armées (project FastGeneII) ; French COVID Cohort Study Group Laurent Abel, Amal Abrous, Claire Andrejak, François Angoulvant, Delphine Bachelet, Marie Bartoli, Sylvie Behilill, Marine Beluze, Krishna Bhavsar, Lila Bouadma, Minerva Cervantes-Gonzalez, Anissa Chair, Charlotte Charpentier, Léo Chenard, Catherine Chirouze, Sandrine Couffin-Cadiergues, Camille Couffignal, Marie-Pierre Debray, Dominique Deplanque, Diane Descamps, Alpha Diallo, Fernanda Dias da Silva, Céline Dorival, Xavier Duval, Philippine Eloy, Vincent Enouf, Hélène Esperou, Marina Esposito-Farese, Manuel Etienne, Aline-Marie Florence, Alexandre Gaymard, Jade Ghosn, Tristan Gigante, Morgane Gilg, François Goehringer, Jérémie Guedj, Ikram Houas, Isabelle Hoffmann, Jean-Sébastien Hulot, Salma Jaafoura, Ouifiya Kafif, Antoine Khalil, Nadhem Lafhej, Cédric Laouénan, Samira Laribi, Minh Le, Quentin Le Hingrat, Soizic Le Mestre, Sophie Letrou, Yves Levy, Bruno Lina, Guillaume Lingas, Denis Malvy, France Mentré, Hugo Mouquet, Nadège Neant, Christelle Paul, Aurélie Papadopoulos, Christelle Paul, Ventzislava Petrov-Sanchez, Gilles Peytavin, Valentine Piquard, Olivier Picone, Manuel Rosa-Calatrava, Bénédicte Rossignol, Patrick Rossignol, Carine Roy, Marion Schneider, Richa Su, Coralie Tardivon, Jean-François Timsit, Sarah Tubiana, Sylvie Van Der Werf, Benoit Visseaux, Aurélie Wiedemann. |
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| Zeitschrift: | ISSN: 1364-8535, 2022 |
| Veröffentlichung: | HAL CCSD ; BioMed Central, 2022 |
| Medientyp: | academicJournal |
| DOI: | 10.1186/s13054-022-04164-0 |
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