High Prevalence of Small Intestinal Bacterial Overgrowth Syndrome in ICU Patients: An Observational Study.

Autor:	Karakosta A; Department of Anaesthesia and Postoperative Intensive Care, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Bousvaros K; Intensive Care Unit, General Hospital of Ioannina 'G. Hatzikosta,' Ioannina, Greece., Margaritis A; National Centre of Emergency Care of Ioannina, Ioannina, Greece., Moschovi P; Intensive Care Unit, General Hospital of Ioannina 'G. Hatzikosta,' Ioannina, Greece., Mousafiri O; Intensive Care Unit, General Hospital of Ioannina 'G. Hatzikosta,' Ioannina, Greece., Fousekis F; Department of Gastroenterology, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Papathanakos G; Intensive Care Unit, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Samara E; Department of Anaesthesia and Postoperative Intensive Care, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Tzimas P; Department of Anaesthesia and Postoperative Intensive Care, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Christodoulou D; Department of Gastroenterology, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Koulouras V; Intensive Care Unit, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Baltayiannis G; Department of Gastroenterology, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
Jazyk:	angličtina
Zdroj:	Journal of intensive care medicine [J Intensive Care Med] 2024 Jan; Vol. 39 (1), pp. 69-76. Date of Electronic Publication: 2023 Jul 24.
DOI:	10.1177/08850666231190284
Abstrakt:	Background: Small intestinal bacterial overgrowth (SIBO), although associated with potentially serious complications, has not been adequately studied in critically ill patients. The primary objective of this study was to assess the prevalence of SIBO in critically ill patients. Secondary outcomes included the assessment of its effect on ventilator-associated pneumonia (VAP), intensive care unit (ICU) length of stay (LOS), and all-cause in-hospital mortality rate. Methods: This prospective observational study was conducted in a mixed medical-surgical ICU. In 52 consecutive ICU patients, a noninvasive modified hydrogen breath test (HBT) with lactulose was employed for SIBO diagnosis. The HBT was conducted at predetermined time intervals (first day of admission; third, fifth, and seventh day of ICU stay). Patients with an abnormal HBT suggesting SIBO on the day of ICU admission were excluded from the study. Participants were classified as either positive or negative based on their HBT on the third, fifth, and/or seventh day. A comparative assessment of demographic data, APACHE II score, incidence of VAP, duration of ICU stay, and all-cause in-hospital mortality was conducted. Multivariate logistic regression analysis was performed to identify the predictive factors for SIBO. Results: The groups were homogeneous in terms of their baseline characteristics. The prevalence of SIBO was 36.5%. The all-cause in-hospital mortality was 34.6%. The presence of SIBO was associated with an increased incidence of VAP ( P  < .001) and a prolonged ICU length of stay ( P  < .033). All-cause in-hospital mortality was similar between the groups. Regarding the results of the multivariate logistic regression model, only age was identified as a statistically significant independent predictor of SIBO (OR 1.08, P  = .018). Conclusions: The prevalence of SIBO in ICU patients appears to be increased. Both early diagnosis and effective treatment are of utmost importance, especially for critically ill patients since it appears to be associated with VAP and prolonged hospitalization. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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