ResB Modulates the Gut-Lung Axis to Promote Microbiome Recovery in Elderly Pneumonia: A Randomized Controlled Trial

Introduction:Pneumonia is a significant cause of morbidity and mortality in the elderly population. Treatment strategies are limited to antibiotics, oxygen therapy, and ventilator support. Whether probiotic formulation (resB Lung Support) helps to reduce the incidence and severity of pneumonia in the elderly population remains unclear.Objective:To evaluate gut microbiota and its association with the incidence and severity of pneumonia in the elderly with and without probiotic formulation.Methods:Elderly patients aged >=60 admitted to ICUs with pneumonia were recruited - fecal 16S rRNA was analyzed. Microbiota composition was compared across time points and between placebo and resB treatment groups. A linear mixed-effects model assessed the effect of resB on taxa abundance.Results:The linear mixed-effects model revealed that Collinsella (p=0.02) and Eggerthella lenta (p=0.08) increased in the placebo group on Day 15. Blautia abundance was higher on Day 30 in the resB group. Within the resB group, B longum (p=0.08) increased significantly on Day 30. Pairwise comparisons showed reductions in Corynebacterium (p=0.06) and Staphylococcus (p=0.07) within the resB group, while Streptococcus was significantly higher in the placebo group on Day 15.Discussion:An increase in opportunistic pathogens (Collinsella and Eggerthella lenta) in the placebo group suggests that resB supplementation may protect the gut microbiota. The rise in butyrate-producing Blautia in the resB group supports enhanced short-chain fatty acid (SCFA) production, indicative of improved host immunity. Reductions in pneumonia-associated bacteria (Staphylococcus and Streptococcus) and Corynebacterium in the resB group highlight their potential role in mitigating pneumonia severity.Conclusion:The resB Lung Support in elderly pneumonia patients increases SCFA-producing bacteria and reduces pathogenic bacteria. These findings suggest its potential role in lowering pneumonia severity and mortality in ICU patients.Key Message:The resB Lung Support enhances SCFA-producing bacteria and reduces pathogenic bacteria, supporting its use in elderly pneumonia patients.