• Kentaro Shimizu, Hiroshi Ogura, Takashi Asahara, Koji Nomoto, Asako Matsushima, Koichi Hayakawa, Hitoshi Ikegawa, Osamu Tasaki, Yasuyuki Kuwagata, and Takeshi Shimazu.
• Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: shimiken@hp-emerg.med.osaka-u.ac.jp.
• Burns. 2015 May 1; 41 (3): e28-33.

IntroductionThe gut is an important target organ after severe insult. Gut microbiota have an important role in immune response. However, the gut microbiota and environment have not been clarified in patients with burns. Therefore, we serially evaluated the gut microbiota and environment in patients with major burns.MethodsFecal samples from five patients with major burns were measured for quantitative evaluation of the gut microbiota.ResultsIn the four survivors of major burns, the numbers of beneficial bacteria, especially those of total obligate anaerobes and Bifidobacterium, initially decreased, but then increased as the condition of the survivors improved. By contrast, the numbers severely decreased in the non-survivor as gut failure and sepsis progressed. The number of pathogenic bacteria such as Pseudomonas and Candida did not continue to increase in the survivors, whereas in the non-survivor the number increased and continued to higher counts. Short-chain fatty acids such as propionic and butyric acids decreased to lower-than-normal levels but tended to increase after recovery in the survivors. The levels remained below normal in the non-survivor.ConclusionsThe gut microbiota and environment are severely altered in patients with major burns. Consequently, abnormal gut conditions may have an influence on the systemic inflammatory response and multiple organ dysfunction syndrome. A novel treatment to maintain the gut microbiota and environment is expected in the future.Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

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