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GI Microbiota Disruption with CRPA in ICU Patients

Clin Infect Dis; ePub 2018 Nov 1; Pettigrew, et al

In a cohort of intensive care unit (ICU) patients, antibiotics differed in their impact on the gastrointestinal (GI) microbiota, while certain bacterial taxa were negatively associated with carbapenem-resistant Pseudomonas aeruginosa (CRPA). Data and peri-rectal swabs were obtained from 109 patients who were classified into 3 groups by CRPA colonization-acquisition status and antimicrobial exposure. Researchers conducted 16S rRNA gene sequencing of an ICU admission swab and ≥1 additional swab and evaluated associations between patient characteristics, medications, and GI microbiota, and CRPA colonization-acquisition. They found:

  • ICU patients had low levels of diversity and high relative abundance of pathobionts.
  • Piperacillin-tazobactam was prescribed more frequently to patients with CRPA colonization-acquisition than those without.
  • Piperacillin-tazobactam was associated with low abundance of potentially protective taxa and increased risk of Enterococcus domination.
  • Opioids were associated with dysbiosis in patients who did not received antibiotics.
  • A group of correlated taxa were associated with lower risk of CRPA colonization-acquisition.


Pettigrew MM, Gent JF, Kong Y, et al. Gastrointestinal microbiota disruption and risk of colonization with carbapenem-resistant Pseudomonas aeruginosa in ICU patients. [Published online ahead of print November 1, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy936.