Exploring the Nasal Microbiome: A Less Invasive Approach to Sepsis Detection

 

Sepsis, a life-threatening disorder caused by the body's excessive response to an infection, poses a tremendous challenge to the medical community because of its high fatality rate, which ranges between 29.9% and 57.5%. Despite the introduction of the Sepsis-3 criteria in 2016, which improved the diagnostic framework by emphasizing organ failure caused by infection as well as the inflammatory response, there is still a need for more effective diagnostic methods. Current sepsis diagnostics suffer from poor culture positivity rates and a lack of extremely sensitive and specific biological markers. This gap emphasizes the critical need for novel, reliable biomarkers for early and accurate sepsis diagnosis. 

The standard method of diagnosing sepsis is detecting infections and the resulting inflammatory reactions. However, this strategy is frequently insufficient due to the complexity of sepsis, which involves several biochemical processes and can be induced by a variety of diseases. The low rate of culture-positive patients, along with the presence of non-culturable microorganisms, complicates accurate sepsis diagnosis. These obstacles have prompted researchers to investigate alternate diagnostic methods, with a particular emphasis on the human microbiome's role in sepsis development and progression.

Recent research has identified a potential breakthrough in sepsis diagnoses by investigating the human microbiome, namely the nasal and gut bacteria. Although research has demonstrated that an imbalance in the gut microbiome is connected with sepsis, this study implies that the nasal microbiome may provide a more straightforward and reliable diagnostic approach. The nasal microbiota's lesser complexity and variety as compared to the gut microbiota make it a good target for diagnostic model development. Nasal microbiome changes in sepsis patients can reveal specific microbial signatures that distinguish them from non-septic individuals.

The nose microbiota is more effective as a sepsis diagnostic tool than the gut microbiota because it is less complicated and more stable. While the stomach has hundreds of microbial species, making it difficult to detect specific sepsis-related changes, the nasal microbiota contains fewer species, making it easier to identify diagnostic indicators. Furthermore, broad-spectrum antibiotics, which are widely used in ICU patients and drastically alter gut microbiota composition, have a lower impact on the nasal microbiome. This stability enables a more consistent and reliable diagnostic method. 

The study discovered that septic patients had different nasal microbiota profiles, including elevated abundances of particular bacterial genera including Pseudomonas and Klebsiella, both of which are related with respiratory infections and sepsis. The composition of the nasal microbiota reflects the body's reaction to infection and may reveal underlying pulmonary problems, which are typical causes of sepsis. Researchers may use these microbial features to create machine learning algorithms that effectively predict sepsis based on nasal swab data. 

The deployment of a diagnostic model based on nasal microbiota entails collecting nose swabs from patients, doing 16S rRNA sequencing to identify bacterial taxa, and using machine learning algorithms to classify and predict sepsis. The study found that a random forest classifier trained on nasal microbiota data had an AUC of 89.08, indicating great prediction accuracy. The efficacy of this model shows that nasal microbiota analysis could be a useful tool in ICU settings for early sepsis identification, allowing for prompt and focused therapeutic measures.

REFERENCE :

1.Tan X, Liu H, Qiu W, Li Z, Ge S, Luo Y, Zeng N, Chen M, Zhou Q, Cai S, Long J, Cen Z, Su J, Zhou H, He X. 0. The nasal microbiota is a potential diagnostic biomarker for sepsis in critical care units. Microbiol Spectr 0:e03441-23. https://doi.org/10.1128/spectrum.03441-23

 

IMAGE SOURCE :

1. COVER IMAGE: https://www.forbes.com/sites/linhanhcat/2019/06/27/world-microbiome-day/