Bağırsaktan Klinik Hemşirelik Uygulamasına; Mikrobiyom Bilgisinin Hemşirelik Eğitimine Bütünleştirilmesi

Yıl 2025, Cilt: 9 Sayı: 2, 88 - 98, 31.08.2025

Havva Sert , Mustafa Altındiş

https://doi.org/10.34084/bshr.1765401

Öz

Son yıllarda bağırsak mikrobiyomu üzerine yapılan araştırmalar, insan sağlığı ve hastalıkları üzerinde kritik etkileri olan karmaşık mikrobiyal ekosistemi anlamada önemli ilerlemeler sağlamıştır. Bu gelişmeler, mikrobiyom bilgisinin sağlık profesyonelleri, özellikle hemşirelik eğitimi ve klinik uygulamalarına entegre edilmesini zorunlu kılmıştır. Ancak mevcut hemşirelik programlarında mikrobiyomun sistemik etkileri, disbiyoz, inflamasyon ve klinik sonuçlarla ilişkisi yeterince ele alınmamaktadır. Bu derleme, bağırsak mikrobiyomunun yapısı, fonksiyonları ve hastane ortamında karşılaşılan mikrobiyal dinamikler ışığında hemşirelik eğitiminde mikrobiyom bilgisinin bütünleştirilmesinin gerekliliğini ortaya koymaktadır. Klinik uygulamalarda mikrobiyota temelli hasta bakım stratejilerinin geliştirilmesi, hemşirelerin multidisipliner sağlık ekibi içinde rolünü güçlendirecek ve hasta bakım kalitesini artıracaktır. Bu bağlamda, hemşirelik müfredatına mikrobiyom biliminin sistematik olarak dahil edilmesi; araştırma, eğitim ve uygulama arasında köprü kurarak sağlık sonuçlarını iyileştirme potansiyeline sahiptir.

Anahtar Kelimeler

Bağırsak Mikrobiyomu , Disbiyoz , Hemşirelik Eğitimi , Klinik Uygulama

From the Gut to Nursing Practice: Integrating microbiome knowledge in nursing education

Öz

Recent advances in gut microbiome research have significantly deepened our understanding of the complex microbial ecosystems that critically influence human health and disease. These developments necessitate the integration of microbiome knowledge into healthcare professionals’ education, especially nursing curricula and clinical practice. However, current nursing programs inadequately address the systemic impacts of the microbiome, dysbiosis, inflammation, and their clinical implications. This review highlights the imperative of incorporating gut microbiome science into nursing education, considering microbiota structure, function, and dynamics in clinical settings. Developing microbiota-based patient care strategies in clinical nursing practice will empower nurses’ roles within multidisciplinary teams and improve care quality. Systematic inclusion of microbiome science in nursing curricula can bridge research, education, and practice, ultimately enhancing patient outcomes.

Anahtar Kelimeler

Gut Microbiome , Nursing Education , Dysbiosis , Clinical Practice

Kaynakça

• 1. Lloyd-Price J, Abu-Ali G, Huttenhower C. The healthy human microbiome. Genome Med. 2016 Apr 26;8(1):51. doi: 10.1186/s13073-016-0307-y.
• 2. Lynch SV, Pedersen O. The human intestinal microbiome in health and disease. N Engl J Med. 2016 Dec 15;375(24):2369-2379. doi: 10.1056/NEJMra1600266.
• 3. Wilson ID, Nicholson JK. Gut microbiome interactions with drug metabolism, efficacy, and toxicity. Transl Res. 2017 Jan;179:204-222. doi: 10.1016/j.trsl.2016.08.002.
• 4. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2012 Jun 14;486(7402):207-14. doi: 10.1038/nature11234.
• 5. Sekirov I, Russell SL, Antunes LC, Finlay BB. Gut microbiota in health and disease. Physiol Rev. 2010 Jul;90(3):859-904. doi: 10.1152/physrev.00045.2009.
• 6. Ding T, Schloss PD. Dynamics and associations of microbial community types across the human body. Nature. 2014 Jan 23;509(7500):357-60. doi: 10.1038/nature13178.
• 7. Bäckhed F, Roswall J, Peng Y, et al. Dynamics and stabilization of the human gut microbiome during the first year of life. Cell Host Microbe. 2015 May 13;17(5):690-703. doi: 10.1016/j.chom.2015.04.004.
• 8. Zhang Y, Zhang L, Zhou X, et al. Antibiotic-induced microbiome depletion protects against MHC-mismatched skin graft rejection. Nat Commun. 2015 Jun 18;6:7383. doi: 10.1038/ncomms8383.
• 9. Mayer EA, Tillisch K, Gupta A. Gut/brain axis and the microbiota. J Clin Invest. 2015 Jan;125(3):926-38. doi: 10.1172/JCI76304.
• 10. Bravo JA, Forsythe P, Chew MV, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5. doi: 10.1073/pnas.1102999108.
• 11. Cryan JF, Dinan TG. Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci. 2012 Oct;13(10):701-12. doi: 10.1038/nrn3346.
• 12. Maynard CL, Elson CO, Hatton RD, Weaver CT. Reciprocal interactions of the intestinal microbiota and immune system. Nature. 2012 Sep 20;489(7415):231-41. doi: 10.1038/nature11551.
• 13. Zhao Q, Elson CO. Adaptive immune education by gut microbiota antigens. Immunology. 2018 Jan;154(1):28-37. doi: 10.1111/imm.12874.
• 14. Haak BW, Littmann ER, Hayden RT, et al. Impact of gut colonization with butyrate-producing microbiota on respiratory viral infection following allogeneic hematopoietic cell transplantation. Blood. 2018 Nov 1;131(23): 2657-2668. doi: 10.1182/blood-2017-10-808842.
• 15. Rosshart SP, Vassallo BG, Angeletti D, et al. Wild Mouse Gut Microbiota Promotes Host Fitness and Improves Disease Resistance. Cell. 2017 Oct 5;171(5):1015-1028.e13. doi: 10.1016/j.cell.2017.09.016.
• 16. Shimizu K, Ogura H, Goto M, et al. Altered gut flora and environment in patients with severe systemic inflammatory response syndrome. J Trauma. 2011 Jan;70(1):235-43. doi: 10.1097/TA.0b013e3181fd38b6.
• 17. Ojima M, Motooka D, Shimizu K, et al. Metagenomic analysis reveals dynamic changes of whole gut microbiota in the acute phase of intensive care unit patients. Digest Dis Sci. 2016 Mar;61(3):710-9. doi: 10.1007/s10620-015-3959-x.
• 18. Buffie CG, Pamer EG. Microbiota-mediated colonization resistance against intestinal pathogens. Nat Rev Immunol. 2013 Dec;13(12):790-801. doi: 10.1038/nri3535.
• 19. Ubeda C, Taur Y, Jenq RR, et al. Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humans. J Clin Invest. 2010 Dec;120(12):4332-41. doi: 10.1172/JCI43918.
• 20. Le Bastard Q, Al-Ghalith GA, Gregoire M, et al. Systematic review: human gut dysbiosis induced by non-antibiotic prescription medications. Aliment Pharmacol Ther. 2018 Jul;47(3):332-345. doi: 10.1111/apt.14548.
• 21. Lam SW, Ariza-Heredia EJ, Lesnick TG, et al. Fecal microbiota transplantation for treatment of Clostridioides difficile infection in immunocompromised patients. Clin Infect Dis. 2020 Oct 28;71(10):2546-2550. doi: 10.1093/cid/ciaa248.
• 22. Maki KA, Diallo AF, Lockwood MB, Franks AT, Green SJ, Joseph PV. Considerations when designing a microbiome study: Implications for nursing science. Biological Research for Nursing. 2019;21(2):125-141. doi:10.1177/1099800418811639.
• 23. Clark TA, Butler K, Wilson DR. CE: Gut microbiome and health. American Nurse Journal. 2024;19(4):6-11. doi:10.51256/anj042406.
• 24. Szychowiak P, Villageois-Tran K, Patrier J, Timsit JF, Ruppé É. The role of the microbiota in the management of intensive care patients. Annals of Intensive Care. 2022;12(1):3. doi:10.1186/s13613-021-00976-5.
• 25. Fu MR, Kurnat-Thoma E, Starkweather A, et al. Precision health: A nursing perspective. International Journal of Nursing Sciences. 2019;7(1):5-12. doi:10.1016/j.ijnss.2019.12.008.
• 26. Lockwood MB, Green SJ. Clinical care is evolving: The microbiome for advanced practice nurses. Journal of the American Association of Nurse Practitioners. 2020;32(4):290-292. doi:10.1097/JXX.0000000000000379.
• 27. Durrant RJ, Doig AK, Buxton RL, Fenn JP. Microbiology education in nursing practice. Journal of Microbiology & Biology Education. 2017;18(2):18.2.43. doi:10.1128/jmbe.v18i2.1224.
• 28. Gupta V, Kumar R, Sood U, Singhvi N. Reconciling hygiene and cleanliness: A new perspective from human microbiome. Indian Journal of Microbiology. 2020;60(1):37-44. doi:10.1007/s12088-019-00839-5.
• 29. Ferranti EP, Grossmann R, Starkweather A, Heitkemper M. Biological determinants of health: Genes, microbes, and metabolism – exemplars of nursing science. Nursing Outlook. 2017;65(5):506-514. doi:10.1016/j.outlook.2017.03.013.
• 30. Mueller-Burke D, Bindon S, Akintade B, Idzik S. The AACN essentials: An intentional framework for successful implementation. Journal of Professional Nursing. 2024;52:62-69. doi:10.1016/j.profnurs.2024.03.009.
• 31. Dewell SL, Muglia KA, Graves LY, et al. Essentials of genomics in nursing undergraduate education: A discussion paper. Nurse Education in Practice. 2024;81:104175. doi:10.1016/j.nepr.2024.104175.
• 32. Melby MK, Mylabathula S, Azad MB, et al. Public health microbiome curriculum: Looking below the tip of the iceberg for approaches to population health. Microbial Biotechnology. 2025;18(6):e70160. doi:10.1111/1751-7915.70160.
• 33. Thomas A, Davis D, Faue J, Kicker S. Learning from feces: A case study teaching microbiome analysis. Frontiers in Education. 2025;9:1380117. doi:10.3389/feduc.2024.1380117.
• 34. Ayer Miller C. Virtual lab simulations in undergraduate microbiology: Aligning with ASM curriculum guidelines. J Microbiol Biol Educ. 2025;26(1):e00203-24. doi:10.1128/jmbe.00203-24
• 35. Chitra E, Mubin SA, Nadarajah VD, et al. A 3D interactive microbiology laboratory via virtual reality for enhancing practical skills. Scientific Reports. 2024;14(1):12809. doi:10.1038/s41598-024-63601-y.
• 36. Conley YP, Heitkemper M, McCarthy D, et al. Educating future nursing scientists: Recommendations for integrating omics content in PhD programs. Nursing Outlook. 2015;63(4):417-427. doi:10.1016/j.outlook.2015.06.006.
• 37. Green E, Seaman C, Vanniasinkam T. Microbiology education for rural nurses: Continuing professional development strategies. Microbiology Australia. 2023;44(3):162-165. doi:10.1071/MA23045.
• 38. Gilbert JA, Blaser MJ, Caporaso JG, et al. Current understanding of the human microbiome. Nat Med. 2018 Apr;24(4):392-400. doi: 10.1038/nm.4517.
• 39. Suez J, Zmora N, Segal E, Elinav E. The pros, cons, and many unknowns of probiotics. Nat Med. 2019 May;25(5):716-729. doi: 10.1038/s41591-019-0439-x.
• 40. Schmid-Hempel P, Reber-Funk C, Nötzold R, et al. Host-parasite interactions: a multilayered perspective. J Exp Biol. 2020 Jan 1;223(Pt 1):jeb203903. doi: 10.1242/jeb.203903.
• 41 .Zmora N, Zilberman-Schapira G, Suez J, et al. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell. 2018 Nov 15;174(6):1388-1405.e21. doi: 10.1016/j.cell.2018.08.041.
• 42. Duvallet C, Gibbons SM, Gurry T, et al. Meta-analysis of gut microbiome studies identifies disease-specific and shared responses. Nat Commun. 2017 Jul 25;8(1):1784. doi: 10.1038/s41467-017-01973-8.
• 43. O’Toole PW, Marchesi JR, Hill C. Next-generation probiotics: the spectrum from probiotics to live biotherapeutics. Nat Microbiol. 2017 Nov;2:17057. doi: 10.1038/nmicrobiol.2017.57.
• 44. McFarland LV. From yaks to yogurt: the history, development, and current use of probiotics. Clin Infect Dis. 2015 Oct 1;60 Suppl 2(Suppl 2):S85-90. doi: 10.1093/cid/civ054.
• 45. Plaza-Diaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Mechanisms of action of probiotics. Adv Nutr. 2019 Jan 1;10(suppl_1):S49-S66. doi: 10.1093/advances/nmy063.
• 46. Nicholson JK, Holmes E, Kinross J, et al. Host-gut microbiota metabolic interactions. Science. 2012 Jun 8;336(6086):1262-7. doi: 10.1126/science.1223813.
• 47. Marchesi JR, Adams DH, Fava F, et al. The gut microbiota and host health: a new clinical frontier. Gut. 2016 Feb;65(2):330-9. doi: 10.1136/gutjnl-2015-309990.
• 48. Kelly JR, Borre Y, O'Brien C, et al. Transferring the blues: depression-associated gut microbiota induces neurobehavioural changes in the rat. J Psychiatr Res. 2016 May;82:109-18. doi: 10.1016/j.jpsychires.2016.07.019.
• 49. Ng SC, Tilg H, Ding S, et al. The role of microbiome in human health and disease: an introduction for clinicians. Gut. 2020 May;69(5):910-920. doi: 10.1136/gutjnl-2019-319202.
• 50. Thursby E, Juge N. Introduction to the human gut microbiota. Biochem J. 2017 Mar 28;474(11):1823-1836. doi: 10.1042/BCJ20160510.
• 51. Lynch SV, Pedersen O. The human intestinal microbiome in health and disease. N Engl J Med. 2016 Dec 15;375(24):2369-2379. doi: 10.1056/NEJMra1600266.
• 52. Chiu CY, Chan YL, Tsai MH, et al. Implementation of microbiome research into clinical practice: challenges and opportunities. Microbiome. 2021 Jun 9;9(1):85. doi: 10.1186/s40168-021-01059-1.