Effects of sepsis and its treatment measures on intestinal flora structure in critical care patients

Table 1 Comparison of the general information among the three groups of individuals

Indicator	Control group (n = 10)	Non-sepsis group (n = 10)	Sepsis group (n = 10)	H/F/χ2/Z/t value	P value
Age (yr, mean ± SD)	55 (48.75, 55.25)	59 (50.00, 74.00)a	63.50 (44.75, 76.25)a,b	2.05	0.36
BMI (kg/m2, mean ± S)	23.95 ± 2.04	27.19 ± 4.40a	23.91 ± 4.09a,b	2.64	0.09
Underlying disease (cases)				0.84	0.65
Multiple injuries		3	4
Malignant tumor		5	3
Other diseases		2	3
Type of operation (cases)				0.00	1.00
Surgery on abdominal hollow viscera	-	5	5
Surgery on non-abdominal hollow viscera	-	5	5
APACHE II score on day 1 [points, M (P25, P75)]	-	10.00 (7.00, 17.00)	19.00 (15.25, 21.50)	−2.40	0.02
SOFA score on day 1 (points, mean ± SD)	-	3.30 ± 1.42	10.80 ± 2.97	−7.20	0.00

APACHE II score: Acute Physiologic Assessment and Chronic Health Evaluation II Scoring System; SOFA score: Sequential Organ Failure Assessment Score; BMI: Body mass index.

^aP < 0.05.

^bP < 0.01.

Table 2 General clinical information of the patients in the sepsis group

Patient No.	Primary infection site	Surgical site	Categories of antibiotics used within 7 d after admission to the ICU
S1	Lungs	-	Broad-spectrum penicillins
S2	Abdominal cavity	Hollow viscera	Carbapenems + glycopeptides
S3	Lungs	Hollow viscera	Carbapenems + oxazolidinones
S4	Lungs	Joint	Broad-spectrum penicillins + carbapenems
S5	Abdomen	Hollow viscera	Broad-spectrum penicillins + glycopeptides
S6	Lungs	-	Broad-spectrum penicillins + tetracyclines
S7	Lungs	-	Carbapenems + broad-spectrum penicillins
S8	Abdominal cavity	-	Carbapenems
S9	Abdominal cavity	Hollow viscera	Carbapenems
S10	Abdominal cavity	Hollow viscera	Carbapenems + glycopeptides

Note: Sn represents the sepsis patient number n in the sepsis group; e.g., S1 represents sepsis patient No. 1. ICU: Intensive care unit.

Table 3 Pathogenic bacteria isolated in the sepsis group

Pathogenic bacteria	Cultured sample	Patient No.	Corresponding sample collection time (day n after admission to the ICU)
Acinetobacter baumannii	Sputum	S5, S6, S8	4, 13, 23
Stenotrophomonas maltophilia	Sputum	S6, S7	1, 8
Enterococcus	Sputum	S7	23
Escherichia coli	Blood	S7	1

Sn represents the sepsis patient number n in the sepsis group; e.g., S5 represents sepsis patient No. 5. In the table, sputum and blood samples from patients in the sepsis group were subjected to qualitative cultures, and bacterial colonization and contamination were ruled out. ICU: Intensive care unit.

Table 4 Statistical comparison of the α-diversity indexes of the intestinal flora in the three groups of individuals

α-diversity index	P value
	Control-median vs non-sepsis-median	Control-median vs sepsis-median	Non-sepsis-median vs sepsis-median
Ace	0.003	0.002	0.247
Chao	0.002	0.003	0.393
Shannon	0.023	0.035	0.795
Simpson	0.035	0.023	0.739
Observed OTUs	0.001	0.002	0.623

The Ace and Chao indexes reflect the microbial abundances in samples. Larger values indicate higher microbial abundance. The Shannon and Simpson indexes reflect the microbial diversity of samples. A larger Shannon index indicates a higher diversity, whereas a larger Simpson index indicates a lower diversity. P < 0.05 was considered statistically significant. OTUs: Operational taxonomic units.

Table 5 Variation in the α-diversity indexes of the intestinal flora in patients with sepsis within 1 wk of treatment (days 1, 3, and 7 after intensive care unit admittance)

α-diversity index	P value
	Day 1 vs day 3	Day 1 vs day 7	Day 3 vs day 7
Ace	0.066	0.121	0.347
Chao	0.205	0.384	0.595
Shannon	0.653	0.307	0.487
Simpson	0.595	0.241	0.347
Observed OTUs	0.177	0.384	0.623

OTUs: Operational taxonomic units.