ArticleNature medicine2023
Dysbiosis of a microbiota-immune metasystem in critical illness is associated with nosocomial infections.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
86 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Gut microbiome changes in critically ill adults: a systematic review of longitudinal sequencing studies.Critical care science · 2026Pooled it
- The effect of antibiotics on the intestinal microbiota in children - a systematic review.Frontiers in allergy · 2024Pooled it
- Impact of fiber-containing enteral nutrition on microbial community dynamics in critically ill trauma patients: a pilot-randomized trial.BMC medicine · 2025Trial
- Impact of doxycycline post-exposure prophylaxis for sexually transmitted infections on the gut microbiome and antimicrobial resistome.Nature medicine · 2025Trial
- Gut microbiota dysbiosis exacerbates acute pancreatitis viaGut microbes · 2026Article
- Microbiome ecology and antibiotic treatment failure: resistance spread, microbial competition and community engineering.Microbial genomics · 2026Review
- Gut dysbiosis‑derived butyrate loss predicts feeding intolerance: Multiomics evidence guiding nurse‑driven microbiota‑supportive interventions (Review).Molecular medicine reports · 2026Review
- Alterations of the host-lung microbiome metasystem in systemic inflammatory response syndrome is associated with secondary pneumonia.Cell reports. Medicine · 2026Article
- Energy-assisted CRISPR cleavage and probiotic vesicle signaling platform: Microbiome reprogramming for homeostasis.Science advances · 2026Article
- Clinical Significance of Intestinal Fungal Overgrowth: Integrating the Gut Mycobiome into Modern Gastroenterology.Microorganisms · 2026Review
- Strategies to prevent cross-transmission of multidrug-resistant microorganisms in intensive care units: A narrative review.Journal of intensive medicine · 2026Review
- Early Gut Microbiome-Short-Chain Fatty Acid Axis Disruption May Be Associated with Delayed Recovery in Critically Ill Children.Nutrients · 2026Observational
- The intestinal microbiota impacts nutritional immunity and resistance toProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Factors influencing antibiotic-resistant bacteria colonization among community and hospitalized individuals in Chennai, India: an Antibiotic Resistance in Communities and Hospitals (ARCH) study.Antimicrobial resistance and infection control · 2026Article
- [Differential analysis of gut microbiome in patients with periprosthetic joint infection, aseptic failure, and osteoarthritis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Differential disease tolerance mediates sex-biased illness severity in sepsis.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- The impact of gut microbiota on leukemia and prospects for novel therapies.Infectious medicine · 2026Review
- Impaired systemic antibody response against gut microbiota pathobionts in critical illness and susceptibility to nosocomial infections.Intensive care medicine experimental · 2026Article
- Data-driven spatial-temporal framework for exploring the heterogeneity and temporality of sepsis.Chinese medical journal · 2026Review
- Gastrointestinal axis in post-traumatic sepsis: from molecular mechanisms to translational perspectives.Frontiers in immunology · 2026Review
26 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
Critically ill patients in intensive care units experience profound alterations of their gut microbiota that have been linked to a high risk of hospital-acquired (nosocomial) infections and adverse outcomes through unclear mechanisms. Abundant mouse and limited human data suggest that the gut microbiota can contribute to maintenance of systemic immune homeostasis, and that intestinal dysbiosis may lead to defects in immune defense against infections. Here we use integrated systems-level analyses of fecal microbiota dynamics in rectal swabs and single-cell profiling of systemic immune and inflammatory responses in a prospective longitudinal cohort study of critically ill patients to show that the gut microbiota and systemic immunity function as an integrated metasystem, where intestinal dysbiosis is coupled to impaired host defense and increased frequency of nosocomial infections. Longitudinal microbiota analysis by 16s rRNA gene sequencing of rectal swabs and single-cell profiling of blood using mass cytometry revealed that microbiota and immune dynamics during acute critical illness were highly interconnected and dominated by Enterobacteriaceae enrichment, dysregulated myeloid cell responses and amplified systemic inflammation, with a lesser impact on adaptive mechanisms of host defense. Intestinal Enterobacteriaceae enrichment was coupled with impaired innate antimicrobial effector responses, including hypofunctional and immature neutrophils and was associated with an increased risk of infections by various bacterial and fungal pathogens. Collectively, our findings suggest that dysbiosis of an interconnected metasystem between the gut microbiota and systemic immune response may drive impaired host defense and susceptibility to nosocomial infections in critical illness.
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What OpenQuestion holds
Registered trials
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.