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2016 ; 45
(5
): 475-82
Nephropedia Template TP
gab.com Text
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The Shift of an Intestinal "Microbiome" to a "Pathobiome" Governs the Course and
Outcome of Sepsis Following Surgical Injury
#MMPMID26863118
Krezalek MA
; DeFazio J
; Zaborina O
; Zaborin A
; Alverdy JC
Shock
2016[May]; 45
(5
): 475-82
PMID26863118
show ga
Sepsis following surgical injury remains a growing and worrisome problem
following both emergent and elective surgery. Although early resuscitation
efforts and prompt antibiotic therapy have improved outcomes in the first 24 to
48? h, late onset sepsis is now the most common cause of death in modern
intensive care units. This time shift may be, in part, a result of prolonged
exposure of the host to the stressors of critical illness which, over time, erode
the health promoting intestinal microbiota and allow for virulent pathogens to
predominate. Colonizing pathogens can then subvert the immune system and
contribute to the deterioration of the host response. Here, we posit that novel
approaches integrating the molecular, ecological, and evolutionary dynamics of
the evolving gut microbiome/pathobiome during critical illness are needed to
understand and prevent the late onset sepsis that develops following prolonged
critical illness.