Dramatic changes of the gut flora immediately after severe and sudden insults.

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Background The gut flora is crucially involved in hosthomeostasis. However, the changes in the gut flora duringthe early phase of a critical illness are unknown.Aims We investigated the changes in the gut flora at anearly phase of severe insult in critically ill patients.Methods Fifteen patients who experienced a sudden andsevere insult were studied, along with 12 healthy volunteersas the control group. Fecal samples were acquiredfrom the subjects by swabs of the rectum within 6 h afteradmission to the emergency room (day 0). Samples wereserially collected from patients until day 14. Samples werealso collected from control subjects.Results On day 0, total bacterial counts were decreased toone-thousandth the number of the control subjects, inparticular, obligate anaerobes and Lactobacillus were significantlydecreased. In addition, on day 0, the major shortchainfatty acids of the patients were significantly lowerthan those of the control subjects. The gut flora and theconcentrations of major short-chain fatty acids did notrecover to normal levels. In contrast, Enterococcus andPseudomonas increased during the study period