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Open Access

Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury

Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mary F Nelson, Eric M Campion, Rachael A Callcut, Carolyn S Calfee, Brandon J Lamere, Douglas W Fadrosh, Susan Lynch, Mitchell Jay Cohen
DOI: 10.1136/tsaco-2017-000108 Published 23 October 2017
Benjamin M Howard
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Lucy Z Kornblith
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Sabrinah A Christie
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Amanda S Conroy
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Mary F Nelson
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Eric M Campion
2 Department of Surgery, Denver Health and Hospital Authority, University of Colorado, Denver, Colorado, USA
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Rachael A Callcut
1 Department of Surgery, San Francisco General Hospital, University of California San Francisco, California, USA
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Carolyn S Calfee
3 Division of Pulmonary and Critical Care Medicine, Departments of Medicine and Anesthesia, University of California San Francisco, California, USA
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Brandon J Lamere
4 Division of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA
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Douglas W Fadrosh
4 Division of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA
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Susan Lynch
4 Division of Gastroenterology, Department of Medicine, University of California San Francisco, California, USA
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Mitchell Jay Cohen
2 Department of Surgery, Denver Health and Hospital Authority, University of Colorado, Denver, Colorado, USA
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  • Figure 1
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    Figure 1

    Beta-diversity changes during 72 hours. A significant difference between the microbial community composition of critically injured patients from admission (0 hour), 24 or 72 hours after admission was observed when analyzing the weighted UniFrac matrices, as depicted in three-dimensional Principle Coordinates Analysis. This implies that there is both a phylogenetic and relative abundance component to the difference between the microbial communities.

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    Figure 2

    Microbial changes over time, depicted at order taxonomic level.

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    Figure 3

    Significantly enriched OTUs at 0 vs. 72 hours. Significantly enriched OTUs (p<0.05, q<0.05) were determined using negative binomial regression. When comparing the 0 and 72 hours samples there were 124 and 151 significantly enriched OTUs at each time point, respectively. OTU, operational taxonomic units

Tables

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  • Table 1

    Patient demographics, injury characteristics, treatments and outcomes

    TransfusionAntibiotics
    AgeSexRaceISSMechanism0 hour24 hours*72 hours‡0 hour24 hours72 hoursTBIICUOutcome
    26FemaleAsian25BluntNoYesNoNoYesNoYes4Alive
    26MaleAsian27BluntYesYesYesNoYesYesYes14Alive
    33MaleLatino17BluntNoNoNoNoYesYesYes25Alive
    91MaleAsian17BluntNoNo†NoNo†Yes13Alive
    60MaleWhite75BluntNoNoNoNoNoNoYes15Dead
    37MaleLatino30BluntNoNo†NoNo†Yes19Alive
    42MaleWhite43BluntYesYesYesNoYesYesNo10Alive
    52MaleLatino75BluntYesYesYesNoYesYesYes4Dead
    85MaleAsian30BluntNoYes†NoYes†No25Alive
    70MaleWhite41BluntNoYesYesNoYesYesYes30Alive
    46MaleWhite14PenetratingNoYesYesNoYesNoNo8Alive
    20MaleLatino21PenetratingNoYesNoNoYesYesNo8Alive
    • *Product transfused in the 0 to 24-hour interval.

    • †No sample collected.

    • ‡Product transfused in the 25 to 72-hour interval.

    • ICU, days in intensive care unit; ISS, Injury Severity Score; TBI, traumatic brain injury.

  • Table 2

    Measures of alpha-diversity in stool microbiome (p Values)

    EvennessRichnessShannon
    diversity
    Simpson diversityInverse Simpson diversity
    Injured biome over time*0.2790.8370.5740.2680.421
    Uninjured vs injured biome†0.1480.3900.1670.2610.136
    • *Stool microbiome of injured patients at 0 vs. 24 hours vs. 72 hours.

    • †Stool microbiome of uninjured vs. injured patients at 0 hour.

  • Table 3

    Measures of beta-diversity in stool microbiome (p Values)

    CanberraBray-CurtisUnweighted UniFracWeighted UniFrac
    Injured biome over time*0.6270.1790.6810.023
    Uninjured vs injured biome†0.0640.1770.1590.123
    • *Stool microbiome of injured patients at 0 vs. 24 hours vs. 72 hours.

    • †Stool microbiome of uninjured vs. injured patients at 0 hour.

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Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury
Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mary F Nelson, Eric M Campion, Rachael A Callcut, Carolyn S Calfee, Brandon J Lamere, Douglas W Fadrosh, Susan Lynch, Mitchell Jay Cohen
Trauma Surg Acute Care Open Aug 2017, 2 (1) e000108; DOI: 10.1136/tsaco-2017-000108

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Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury
Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mary F Nelson, Eric M Campion, Rachael A Callcut, Carolyn S Calfee, Brandon J Lamere, Douglas W Fadrosh, Susan Lynch, Mitchell Jay Cohen
Trauma Surg Acute Care Open Aug 2017, 2 (1) e000108; DOI: 10.1136/tsaco-2017-000108
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Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury
Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mary F Nelson, Eric M Campion, Rachael A Callcut, Carolyn S Calfee, Brandon J Lamere, Douglas W Fadrosh, Susan Lynch, Mitchell Jay Cohen
Trauma Surgery & Acute Care Open Aug 2017, 2 (1) e000108; DOI: 10.1136/tsaco-2017-000108
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