Imperial College London
Alternate

DrAnishaWijeyesekera

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Lecturer
 
 
 
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Contact

 

anisha.wijeyesekera04 Website

 
 
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Location

 

380ASir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wijeyesekera:2019:10.1097/CCM.0000000000003841,
author = {Wijeyesekera, A and Wagner, J and De, Goffau M and Thurston, S and Rodrigues, Sabino A and Zaher, S and White, D and Ridout, J and Peters, MJ and Ramnarayan, P and Branco, RG and Torok, ME and Valla, F and Meyer, R and Klein, N and Frost, G and Parkhill, J and Holmes, E and Pathan, N},
doi = {10.1097/CCM.0000000000003841},
journal = {Critical Care Medicine},
pages = {e727--e734},
title = {Multi-compartment profiling of bacterial and host metabolites identifies intestinal dysbiosis and its functional consequences in the critically ill child},
url = {http://dx.doi.org/10.1097/CCM.0000000000003841},
volume = {47},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Adverse physiology and antibiotic exposure devastate the intestinal microbiome in critical illness. Time and cost implications limit the immediate clinical potential of microbial sequencing to identify or treat intestinal dysbiosis. Here, we examined whether metabolic profiling is a feasible method of monitoring intestinal dysbiosis in critically ill children. DESIGN: Prospective multicenter cohort study. SETTING: Three U.K.-based PICUs. PATIENTS: Mechanically ventilated critically ill (n = 60) and age-matched healthy children (n = 55). INTERVENTIONS: Collection of urine and fecal samples in children admitted to the PICU. A single fecal and urine sample was collected in healthy controls. MEASUREMENTS AND MAIN RESULTS: Untargeted and targeted metabolic profiling using 1H-nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry or urine and fecal samples. This was integrated with analysis of fecal bacterial 16S ribosomal RNA profiles and clinical disease severity indicators. We observed separation of global urinary and fecal metabolic profiles in critically ill compared with healthy children. Urinary excretion of mammalian-microbial co-metabolites hippurate, 4-cresol sulphate, and formate were reduced in critical illness compared with healthy children. Reduced fecal excretion of short-chain fatty acids (including butyrate, propionate, and acetate) were observed in the patient cohort, demonstrating that these metabolites also distinguished between critical illness and health. Dysregulation of intestinal bile metabolism was evidenced by increased primary and reduced secondary fecal bile acid excretion. Fecal butyrate correlated with days free of intensive care at 30 days (r = 0.38; p = 0.03), while urinary formate correlated inversely with vasopressor requirement (r = -0.2; p = 0.037). CONCLUSIONS: Disruption to the functional activity of the intestinal microbiome may result in worsening organ failure in the critically ill child. P
AU  - Wijeyesekera,A
AU  - Wagner,J
AU  - De,Goffau M
AU  - Thurston,S
AU  - Rodrigues,Sabino A
AU  - Zaher,S
AU  - White,D
AU  - Ridout,J
AU  - Peters,MJ
AU  - Ramnarayan,P
AU  - Branco,RG
AU  - Torok,ME
AU  - Valla,F
AU  - Meyer,R
AU  - Klein,N
AU  - Frost,G
AU  - Parkhill,J
AU  - Holmes,E
AU  - Pathan,N
DO  - 10.1097/CCM.0000000000003841
EP  - 734
PY  - 2019///
SN  - 0090-3493
SP  - 727
TI  - Multi-compartment profiling of bacterial and host metabolites identifies intestinal dysbiosis and its functional consequences in the critically ill child
T2  - Critical Care Medicine
UR  - http://dx.doi.org/10.1097/CCM.0000000000003841
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31169619
UR  - https://insights.ovid.com/crossref?an=00003246-201909000-00022
UR  - http://hdl.handle.net/10044/1/70857
VL  - 47
ER  -
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