title: The Shift of an Intestinal "Microbiome" to a "Pathobiome" Governs the Course and Outcome of Sepsis Following Surgical Injury.
abstract: 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.
authors: Department of Surgery, Center for Surgical Infection Research and Therapeutics Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
authors: Monika A
authors: MA
authors: Krezalek
authors: Jennifer
authors: J
authors: DeFazio
authors: Olga
authors: O
authors: Zaborina
authors: Alexander
authors: A
authors: Zaborin
authors: John C
authors: JC
authors: Alverdy
mesh_terms: D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007362:Intensive Care Units; D007431:Intraoperative Complications / Q000382:microbiology*; D064307:Microbiota / Q000502:physiology*; D011183:Postoperative Complications / Q000382:microbiology*; D018805:Sepsis / Q000382:microbiology* / Q000517:prevention & control