Technology Advancement Enabling the Link of Gut Microbiota with Obesity and Metabolic Disorder

Obesity is a growing epidemic due to an accelerated phase of industrialization and urbanization with the overfed people now outnumbered the underfed. It is the major public health problem with a lot of research interest as it is associated with many complicated chronic disorders such as type-2 diabetes, cardiovascular diseases (CVD) and cancers. A global estimation of 2.8 million deaths per year is due to obesity and there are tremendous on-going efforts to identify hosts and environmental factors that infl uence the cause and pathogenesis of obesity. Concerted efforts from different research groups had successfully shown that obese subjects have altered composition of gut microbiota and transplantation of this microbiota infl uences body weight in the germ-free recipient mice. The advancement of technology had made possible the study of gut microbiota which was unculturable for better understanding of their impact to human health. Rapid deep sequencing of DNA at reasonable cost through various options of platforms followed by data analysis using robust bioinformatic tools are an important way of analysing the gut microbiome. Here we review the role of gut microbiota which modulates host’s metabolic functions and gene expression, facilitating the extraction and storage of energy from the ingested dietary substances and leading to body-weight gain. We will discuss on the different techniques used, focusing on the high-defi nition technologies for the determination of the composition, function and ecology of gut microbiota. This allows the appropriate selection of platform which becomes the key for success of subsequent research

Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study

Purpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI). Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021. We compared older versus younger adults in terms of infection characteristics (clinical signs and symptoms, source, and microbiological data), management (imaging, source control, antimicrobial therapy), and outcomes (28-day mortality and hospital discharge). Results: Among 2111 individuals hospitalized in 219 ICUs with HA-BSI, 563 (27%) were ≥ 75 years old. Compared to younger patients, these individuals had higher comorbidity score and lower functional capacity; presented more often with a pulmonary, urinary, or unknown HA-BSI source; and had lower heart rate, blood pressure and temperature at presentation. Pathogens and resistance rates were similar in both groups. Differences in management included mainly lower rates of effective source control achievement among aged individuals. Older adults also had significantly higher day-28 mortality (50% versus 34%, p < 0.001), and lower rates of discharge from hospital (12% versus 20%, p < 0.001) by this time. Conclusions: Older adults with HA-BSI hospitalized in ICU have different baseline characteristics and source of infection compared to younger patients. Management of older adults differs mainly by lower probability to achieve source control. This should be targeted to improve outcomes among older ICU patients