Infection, sepsis, septic shock and disbiosis monitoring in an intensive care unit

Vedenin A.N., Bystrova O.V., Osipov G.A.
N.D.Zelinsky Institute of Organic Chemistry; Interlab; Moscow, Russia; osipovga@mail.ru

The initial state precedes sepsis is stress, which resulted in dramatic reduced of intestinal wall colonization following with increases primary infection of damaged organs (nosocomial infection). Evaluation of microecological status of 400 patients using method of mass spectrometry of microbial markers (MSMM) showed 10^th order deficit of microbiota content as compare to the normal level. It is common knowledge now, that infection has polymicrobial nature; in each patient it can be observed simultaneous presence from 10 to16 taxa. It was shown in dynamics on 31 patients, that sepsis thrust by Clostridium perfringens, Pseudomonas aeruginosa, Alcaligenes spp. and Staphylococcus. Here in must be mentioned, that these data from two weeks before the shock, and the phenomenon can be easily used for early diagnosis. Than during the shock process, other groups of microorganism are rising contribution such us Clostridium ramosum, Peptostreptococcus anaerobius, Streptococcus species and Nocardia. Second infection order keeps by C. perfringens, Bacillus cereus group and Moraxella/Acinetobacter, as well as Staphylococcus and Pseudomonas. When shock is coming down we can see growing up markers of intestinal microbiota main species: Bifidobacterium, Lactobacillus, Eubacterium and Propionibacterium. This can be explained as protecting and/or curative mechanism, which induces biofilm formation following local stimulation of immunity and protection against pathogens, as well as damaged tissues reparation. It is general that during inflammatory process in infected organs concentration of microbial markers observed inside it, is several orders higher as compare to their level in the blood. Thus method MSMM can significantly reduce the time of selection of rational antibiotic therapy and to oppose septic complications, it can help to improve patient outcomes and reduce the time and cost of hospitalization.