A metagenomic prospective cohort study on gut microbiome composition and clinical infection in Small Bowel Transplantation

What is already known on this topicTwo-thirds of Small Bowel Transplantation recipients develop bacteremia post-transplantation. One-third die of sepsis, commonly with bacteria of gut origin, thought to translocate through the implanted organ. To improve patient outcomes, clinicians must predict and treat infection in a more timely manner.What this study addsOur metagenomic study showed that 4/5 patients had clinically significant infections thought to be of intestinal origin. In all cases, enteric pathogens had demonstrably colonized the gut between 1-10 days prior to invasive clinical infection.How this study might affect research, practice, or policyFecal sampling in SBT patients could be a useful surveillance tool for impeding sepsis with specific gut bacteria. It would allow clinicians to predict organisms likely to cause infection and facilitate personalized antimicrobial prescribing.