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Therapeutic Potential of the Gut Microbiota in the Management of Sepsis

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Annual Update in Intensive Care and Emergency Medicine 2020

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

A diverse and balanced gut microbiota has been described as a key factor to enhance host immunity to both enteric and systemic pathogens. Disturbances of this balance potentially lead to increased susceptibility to sepsis and multidrug-resistant bacterial colonization. On the other hand, several studies have shown that the composition of the gut microbiota is severely affected by sepsis and its treatment, and the transition of a microbiome into a pathobiome has been hypothesized as a driver of mortality from sepsis. In this chapter, we provide an overview of the mechanisms through which the microbiota can contribute to both susceptibility and outcome of sepsis. Moreover, we will describe potential therapeutic effects of gut microbiota modulation in the context of sepsis. The following potential strategies of microbiota modulation have been focused on in preclinical and clinical studies: (1) supplementation of beneficial bacteria by administration of probiotics; (2) dietary interventions and prebiotics, which improve the intestinal microenvironment supporting the growth of beneficial species; and (3) total recolonization of the gut with fecal microbiota transplantation (FMT). Different aspects of these therapeutic strategies (e.g., selection of commensal repletion, the choice of FMT dose, route, and long-term safety) need to be clarified and investigated in order to define the better strategies and the best candidate population in patients with sepsis. The potential benefits emerging from preclinical and clinical studies justify investigation of these promising approaches in critically ill patients with sepsis.

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Author information

Authors and Affiliations

  1. Department of Health Sciences, University of Genoa and Ospedale Policlinico Martino-IST IRCCS, Genoa, Italy

    M. Bassetti

  2. Infectious Disease Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

    A. Bandera & A. Gori

  3. Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy

    A. Bandera & A. Gori

Authors
  1. M. Bassetti
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  2. A. Bandera
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  3. A. Gori
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Editors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Bassetti, M., Bandera, A., Gori, A. (2020). Therapeutic Potential of the Gut Microbiota in the Management of Sepsis. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2020. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-37323-8_24

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  • DOI: https://doi.org/10.1007/978-3-030-37323-8_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-37322-1

  • Online ISBN: 978-3-030-37323-8

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