Observational studyCritical care (London, England)2022
The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut.
Observational study in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Gut microbiome changes in critically ill adults: a systematic review of longitudinal sequencing studies.Critical care science · 2026Pooled it
- Human microbiome and microbiota identification for preventing and controlling healthcare-associated infections: A systematic review.Frontiers in public health · 2022Pooled it
- Gut microbiota dysbiosis in patients with sepsis: a meta-analysis of microbial diversity and taxonomic abundance.Infection · 2026Review
- Gut barrier dysfunction and multidrug-resistant bacterial translocation in adult critical illness: Mechanistic insights from a systematic review.World journal of gastrointestinal pathophysiology · 2026Article
- Longitudinal dynamics of gut microbiota and mycobiota in pneumonia-derived sepsis: evidence of taxonomic stability and trans-kingdom network reorganization.Gut pathogens · 2026Article
- Microbial and inflammatory profiling of pressure injuries and urinary tract infections in spinal cord injury: a prospective cohort study.Scientific reports · 2026Article
- Pathophysiology and Management of Sepsis-associated Acute Kidney Injury.Clinics in chest medicine · 2026Review
- Chronic Antibiotic Use, Gut Microbiota Dysbiosis, and Increased Risk of Colorectal Cancer: An Emerging Threat.Health science reports · 2026Article
- A systematic exploration of gut microbiota-driven blood metabolites in sepsis: an integrated bioinformatics and genetic association study.Frontiers in genetics · 2026Article
- Pre-CRRT furosemide and mortality in sepsis-associated AKI: A retrospective cohort study.PloS one · 2026Article
- Gut microbiota metabolite butyric acid alleviatedBurns & trauma · 2026Article
- Modified Dachengqi Decoction ameliorates sepsis-induced lung injury via the gut microbiota-bile acid axis.Frontiers in cellular and infection microbiology · 2026Article
- Carbohydrate competition by Enterobacteriaceae enhances colonization resistance to carbapenem-resistant hypervirulent K. pneumoniae.Microbiome · 2025Article
- Longitudinal dysbiosis of gut bacteriome and mycobiome in patients with severe acute pancreatitis and its association with mortality.BMC microbiology · 2025Article
- Microbiome-mediated colonization resistance to carbapenem-resistant Klebsiella pneumoniae in ICU patients.NPJ biofilms and microbiomes · 2025Article
- Genetic characteristics and risk factors of extended-spectrum β-lactamase-producingMicrobiology spectrum · 2025Observational
- Unravelling neutropenic enterocolitis: insights from gut microbiota, and intestinal barrier analyses.Experimental hematology & oncology · 2025Article
- Article
- Whole genome comparisons reveal gut-to-lung translocation of Escherichia coli and Burkholderia cenocepacia in two cases of ventilator-associated pneumonia in ICU patients.Respiratory research · 2025Article
- Article
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSecondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the underlying mechanism of infection.
methodsIn this prospective, observational case-control study, a total of 34 septic patients, 33 non-septic intensive care unit (ICU) patients and 10 healthy individuals serving as controls were enrolled. Three hundred and twelve fecal samples were collected and subjected to 16S rRNA gene amplicon sequencing. Metagenome sequencing was performed to identify the homology between dominant CRKP or VRE in the intestine and pathogens isolated from secondary infectious sites. C57/BL mice were established as pseudo germ-free animal model by pretreatment with broad-spectrum antibiotics for two weeks.
resultsThe abundance and diversity of the gut microbiota in septic patients was drastically decreased one week after ICU admission, potentially leading to the enrichment of antibiotic-resistant bacteria, such as CRKP. Furthermore, secondary bloodstream and abdominal infections caused by CRKP or VRE in septic patients occurred after intestinal colonization with the predominant bacterial species. Genomic analysis showed that bacteria isolated from secondary infection had high homology with the corresponding predominant intestinal opportunistic pathogens. In addition, animal model experiments validated the hypothesis that the administration of antibiotics caused the enrichment of CRKP and VRE among the intestinal microbiota, increasing the likelihood of permeation of other tissues and potentially causing subsequent systemic infection in pseudo germ-free mice.
conclusionOur study indicated that the pathogens causing secondary infection in septic patients might originate from the intestinal colonization of pathogens following broad-spectrum antibiotic treatment.
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