ArticleIntensive care medicine2018
Pathogen colonization of the gastrointestinal microbiome at intensive care unit admission and risk for subsequent death or infection.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 138 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
138 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Gut microbiome changes in critically ill adults: a systematic review of longitudinal sequencing studies.Critical care science · 2026Pooled it
- Gut colonization with multidrug resistant organisms in the intensive care unit: a systematic review and meta-analysis.Critical care (London, England) · 2024Pooled it
- Effect of single-patient room design on the incidence of nosocomial infection in the intensive care unit: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- A systematic literature review and expert consensus on risk factors associated to infection progression in adult patients with respiratory tract or rectal colonisation by carbapenem-resistant Gram-negative bacteria.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Pooled it
- Impact of fiber-containing enteral nutrition on microbial community dynamics in critically ill trauma patients: a pilot-randomized trial.BMC medicine · 2025Trial
- Gut Colonization With Vancomycin-Resistant Enterococcus Shapes the Gut Microbiome in the Intensive Care Unit.The Journal of infectious diseases · 2025Trial
- A phase 2 randomized, placebo-controlled trial of inulin for the prevention of gut pathogen colonization and infection among patients admitted to the intensive care unit for sepsis.Critical care (London, England) · 2025Trial
- An open randomized multicentre Phase 2 trial to assess the safety of DAV132 and its efficacy to protect gut microbiota diversity in hospitalized patients treated with fluoroquinolones.The Journal of antimicrobial chemotherapy · 2022Trial
- Microbiome analysis reveals the potential mechanism of herbal sitz bath complementary therapy in accelerating postoperative recovery from perianal abscesses.IET systems biologyTrial
- From gut dysbiosis to eubiosis: understanding microbiome recovery as an ecological process.Gut microbes · 2026Review
- Gut microbiota-driven IL-17A production by hepatic γδ T cells enhances neutrophil defense against systemicVirulence · 2026Article
- Effects of ResB supplementation on gut microbiome composition in elderly pneumonia: a randomized pilot trial.European journal of clinical nutrition · 2026Article
- Gut dysbiosis‑derived butyrate loss predicts feeding intolerance: Multiomics evidence guiding nurse‑driven microbiota‑supportive interventions (Review).Molecular medicine reports · 2026Review
- Clinical and Culture-Based Predictors of Gut Microbiome Alpha Diversity at the Time of ICU Admission.Critical care explorations · 2026Article
- Can We Identify Severe Dysbiosis at the Bedside?Critical care explorations · 2026Article
- Gut barrier dysfunction and multidrug-resistant bacterial translocation in adult critical illness: Mechanistic insights from a systematic review.World journal of gastrointestinal pathophysiology · 2026Article
- A review on antibiotic and non-antibiotic decolonization strategies of multidrug-resistant bacteria in the gastrointestinal tract.Infection · 2026Review
- Longitudinal dynamics of gut microbiota and mycobiota in pneumonia-derived sepsis: evidence of taxonomic stability and trans-kingdom network reorganization.Gut pathogens · 2026Article
- Integrating intestinal microbiome and urinary metabolome data to predict secondary infection in critically ill patients.Critical care (London, England) · 2026Article
- Narrative review on microbiota and sepsis: the host's betrayal?Internal and emergency medicine · 2026Review
78 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
Abstract
purposeLoss of colonization resistance within the gastrointestinal microbiome facilitates the expansion of pathogens and has been associated with death and infection in select populations. We tested whether gut microbiome features at the time of intensive care unit (ICU) admission predict death or infection.
methodsThis was a prospective cohort study of medical ICU adults. Rectal surveillance swabs were performed at admission, selectively cultured for vancomycin-resistant Enterococcus (VRE), and assessed using 16S rRNA gene sequencing. Patients were followed for 30 days for death or culture-proven bacterial infection.
resultsOf 301 patients, 123 (41%) developed culture-proven infections and 76 (25%) died. Fecal biodiversity (Shannon index) did not differ based on death or infection (p = 0.49). The presence of specific pathogens at ICU admission was associated with subsequent infection with the same organism for Escherichia coli, Pseudomonas spp., Klebsiella spp., and Clostridium difficile, and VRE at admission was associated with subsequent Enterococcus infection. In a multivariable model adjusting for severity of illness, VRE colonization and Enterococcus domination (≥ 30% 16S reads) were both associated with death or all-cause infection (aHR 1.46, 95% CI 1.06-2.00 and aHR 1.47, 95% CI 1.00-2.19, respectively); among patients without VRE colonization, Enterococcus domination was associated with excess risk of death or infection (aHR 2.13, 95% CI 1.06-4.29).
conclusionsEnterococcus status at ICU admission was associated with risk for death or all-cause infection, and rectal carriage of common ICU pathogens predicted specific infections. The gastrointestinal microbiome may have a role in risk stratification and early diagnosis of ICU infections.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.