Gut microbiota features associated with sepsis onset and outcomes

Previous epidemiological studies suggest that antibiotic exposure and subsequent disruptions to the gut microbiome may put individuals at risk for sepsis. This study compared clinical features and the gut microbiota in patients who did or did not develop sepsis to investigate whether variation in the gut microbiota is associated with sepsis onset and outcome. Patients admitted to intensive care and hematology units were screened for sepsis. Chart review and validated surveillance for the definition of sepsis was used to match sepsis cases (n=103) and controls (n=206) based on age, gender, and collection date. Archived rectal swabs collected during admission were used for 16S rRNA gene-based sequencing to determine the microbiota composition and a qPCR to determine total bacterial load. In a logistic regression model adjusted for certain clinical features, we observed a high relative abundance of Enterococcus, a high total bacterial load, and decreased relative abundance of butyrate-producing bacteria in patients who developed sepsis. Decreased amoutns of butyrate-producing bacteria were also associated with a higher mortality. These results suggest that the gut microbiota is disrupted at the onset of sepsis, establishing rationale for the development of microbial therapeutics for the prevention and treatment of sepsis.