ArticleGut pathogens2023
Gut microbiome dynamics and associations with mortality in critically ill patients.
Article in Gut pathogens, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Difference analysis of intestinal microbiota in patients in the intensive care unit using different sampling methods: a systematic review and meta-analysis.Frontiers in microbiology · 2025Pooled 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
- Axial Connectivity of the Lung Microbiome: A Review of Interorgan Crosstalk.Comprehensive physiology · 2026Review
- Can We Identify Severe Dysbiosis at the Bedside?Critical care explorations · 2026Article
- Clinical and Culture-Based Predictors of Gut Microbiome Alpha Diversity at the Time of ICU Admission.Critical care explorations · 2026Article
- Preoperative Intestinal Preconditioning to Prevent Postoperative Vasoplegia After Tricuspid Valve Surgery.Annals of thoracic surgery short reports · 2026Article
- Maternal microbiota in relation to mortality, culling, and offspring survival in rabbits.Journal of animal science · 2026Article
- Retrospective analysis of intestinal flora alterations in adults with acute gastrointestinal injury.Frontiers in cellular and infection microbiology · 2026Article
- Gut microbiome in sepsis: from dysbiotic biomarker to precision and palliative decision-making.Frontiers in medicine · 2026Article
- Gut microbiota dysbiosis in sepsis: mechanisms and the gut-organ axis with a focus on lung and brain interactions.Frontiers in microbiology · 2026Review
- Gut microecology in critical illness: mechanisms, biomarkers, and therapeutic strategies - a critical appraisal.Frontiers in gastroenterology (Lausanne, Switzerland) · 2026Review
- The gastrointestinal microbiome in critical illness: A Clinician's guide to mechanisms, emerging tools, and therapeutic questions.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Review
- Gut Microbiome Dysbiosis in COVID-19: A Systematic Review and Meta-Analysis of Diversity Indices, Taxa Alterations, and Mortality Risk.Microorganisms · 2025Review
- Evaluation and Modulation of Gut Microbiome Dysfunction in Chronically Critically Ill Patients: A Prospective Pilot Study.International journal of molecular sciences · 2025Article
- Analysis of ICU resistome dynamics in patients, staff and environment for the identification of predictive biomarkers of sepsis and early mortality.Scientific reports · 2025Article
- Recent Insights into the Evolving Role of the Gut Microbiome in Critical Care.Critical care clinics · 2025Review
- Biological effects of pulmonary, blood and gut microbiome alterations in patients with acute respiratory distress syndrome.ERJ open research · 2025Article
- Comparative analysis of the postadmission and antemortem oropharyngeal and rectal swab microbiota of ICU patients.Scientific reports · 2024Article
- Exploring the lung-gut direction of the gut-lung axis in patients with ARDS.Critical care (London, England) · 2024Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundCritical illness and care within the intensive care unit (ICU) leads to profound changes in the composition of the gut microbiome. The impact of such changes on the patients and their subsequent disease course remains uncertain. We hypothesized that specific changes in the gut microbiome would be more harmful than others, leading to increased mortality in critically ill patients.
methodsThis was a prospective cohort study of critically ill adults in the ICU. We obtained rectal swabs from 52 patients and assessed the composition the gut microbiome using 16 S rRNA gene sequencing. We followed patients throughout their ICU course and evaluated their mortality rate at 28 days following admission to the ICU. We used selbal, a machine learning method, to identify the balance of microbial taxa most closely associated with 28-day mortality.
resultsWe found that a proportional ratio of four taxa could be used to distinguish patients with a higher risk of mortality from patients with a lower risk of mortality (p = .02). We named this binarized ratio our microbiome mortality index (MMI). Patients with a high MMI had a higher 28-day mortality compared to those with a low MMI (hazard ratio, 2.2, 95% confidence interval 1.1-4.3), and remained significant after adjustment for other ICU mortality predictors, including the presence of the acute respiratory distress syndrome (ARDS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio, 2.5, 95% confidence interval 1.4-4.7). High mortality was driven by taxa from the Anaerococcus (genus) and Enterobacteriaceae (family), while lower mortality was driven by Parasutterella and Campylobacter (genera).
conclusionsDysbiosis in the gut of critically ill patients is an independent risk factor for increased mortality at 28 days after adjustment for clinically significant confounders. Gut dysbiosis may represent a potential therapeutic target for future ICU interventions.
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