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A Guide to the Gut Microbiome and its Relevance to Critical Care

22 October 2020
Volume 29 · Issue 19

Abstract

Although it is well-established that particular bacteria may cause gastroenteritis and other infections when present in the gut, it is only recently that scientists have made significant inroads into understanding the huge number of other bacteria and additional microbes that live within the gastrointestinal tract, referred to as the gut microbiome. In particular, it is now recognised that bacteria within the gut microbiome have a wide variety of roles in maintaining different aspects of human health, and that disturbances of these bacteria may potentially cause or contribute to a number of different medical conditions, including particular infections, certain cancers, and chronic conditions, including inflammatory bowel disease. Moreover, there is increasing awareness that these bacteria help determine how the body responds to medication, including antibiotics and chemotherapy. There has been growing interest in different approaches to alter the gut microbiome as a novel approach to medical therapy. This article provides an overview of the importance of the gut microbiome, with a particular focus on critical care.

It has long been understood that the gastrointestinal (GI) tract contains many millions of bacteria and other microbes. Historically, interest in this area has focused on harmful pathogenic bacteria such as Campylobacter or Shigella, which cause infectious gastroenteritis. However, the vast majority of gut bacteria do not usually cause infection, and appear to live in harmony with the body; the profound importance of this wider community of gut microbes was not fully appreciated until recently. One major difficulty in investigating this subject before now has been the lack of laboratory techniques to easily identify many of these microbes; however, over the past 20 years, the arrival of a range of cutting-edge scientific techniques has allowed scientists to study them like never before. For example, from a single stool sample from a healthy person, scientists can now identify material from at least hundreds of different bacterial species, and many thousands of different chemicals related to these bacteria. This has been the launchpad for huge advances in understanding the complex collections of microbes within our GI tract, and for the recognition of their major relevance to medicine and nursing.

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