4.7 Article

Sepsis and the Microbiome: A Vicious Cycle

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 223, Issue -, Pages S264-S269

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiaa682

Keywords

sepsis; microbiome; immune system; antibiotics

Funding

  1. National Institutes of Health [5R01GM062344-18]

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Sepsis-induced alterations in the gut microbiome can lead to organ dysfunction, prompting research into microbiota-directed interventions to address this issue.
Sepsis has been characterized as a dysregulated host response to infection, and the role of the microbiome as a key influencer of this response is emerging. Disruption of the microbiome while treating sepsis with antibiotics can itself result in immune dysregulation. Alterations in the gut microbiome resulting from sepsis and its treatment have been implicated in organ dysfunction typical of sepsis across multiple tissues including the lung, kidney, and brain. Multiple microbiota-directed interventions are currently under investigation in the setting of sepsis, including fecal transplant, the administration of dietary fiber, and the use of antibiotic scavengers that attenuate the effects of antibiotics on the gut microbiota while allowing them to concentrate at the primary sites of infection. The emerging evidence shows that the gut microbiome interacts with various elements of the septic response, and provides yet another reason to consider the judicious use of antibiotics via antibiotic stewardship programs.

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