{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:59:14Z","timestamp":1793746754551,"version":"4.6.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T00:00:00Z","timestamp":1702166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AIIMS","award":["Institute Research Grant No.F.8. 19 I AC-19 \/2021\/"],"award-info":[{"award-number":["Institute Research Grant No.F.8. 19 I AC-19 \/2021\/"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is limited understanding of alteration of gut microbiota and metabolome in children with sepsis\/septic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective observational study carried out in a pediatric intensive care unit of a tertiary care center from 2020 to 2022, patients aged &lt;17 years with sepsis\/septic shock and healthy children (HC) were enrolled. We characterized the gut bacterial compositions by metagenome sequencing and metabolomes by untargeted gas chromatography-mass spectrometry. The primary outcome was to compare the gut microbiota and metabolome of children with sepsis\/septic shock with that of HC. The\n                      <jats:italic toggle=\"yes\">Firmicutes<\/jats:italic>\n                      \/\n                      <jats:italic toggle=\"yes\">Bacteroidetes<\/jats:italic>\n                      (F\/B) ratio was compared between children with sepsis\/septic shock and HC. Key secondary outcomes were to evaluate association of factors associated with a low F\/B ratio in children with sepsis\/septic shock.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 40 children (63% boys) (15 children with sepsis and septic shock and 10 healthy children) with a median (IQR) age of 5.5 (1.5, 10) years were enrolled. In the fecal microbiota, the \u03b1-diversity index including Shannon and Simpson indices of the sepsis\/septic shock groups was significantly lower than that of the HC. The samples lacked bene\ufb01cial\n                      <jats:italic toggle=\"yes\">Bi\ufb01dobacterium<\/jats:italic>\n                      spp. and were dominated by\n                      <jats:italic toggle=\"yes\">Bacteroides<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">Enterococcaceae<\/jats:italic>\n                      . There was reduction in short-chain fatty acids (SCFAs) in patients with sepsis\/septic shock as compared to healthy children. A lower F\/B ratio (\u22641.57) of the gut microbiota discriminated well between children with sepsis\/septic shock and HC. Factors associated with lower F\/B ratio were male gender, clinical GI dysfunction, elevated inflammatory markers, and higher organ failure scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There were significant alterations in the gut microbiota and metabolome in children with sepsis\/septic shock as compared to healthy children. Larger study is needed to confirm these exploratory findings and develop potential therapeutic targets that will improve outcomes in children with sepsis\/septic shock.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666231216361","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T01:25:35Z","timestamp":1702257935000},"page":"514-524","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["The Microbiome and Metabolome of the Gut of Children with Sepsis and Septic Shock"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9807-6550","authenticated-orcid":false,"given":"Jhuma","family":"Sankar","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Thakral","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanchan","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Manav Rachna University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetal","family":"Agarwal","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil Kumar","family":"Kabra","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Lodha","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Rathore","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.136072"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201412-2323OC"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx144"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30119-4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4613-z"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/mSphere.00199-16"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2016.10.020"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1079\/PNS2002207"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00395-21"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-4011-3"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00399.2020"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-28525-z"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2022.04.005"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.21037\/tp-21-51"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.645060"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000360"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000149131.72248.E6"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/0471142727.mb3004s114"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000389"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00427-0"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-594"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-02989-1"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu084"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/157.5.1032"},{"key":"e_1_3_3_27_2","doi-asserted-by":"crossref","unstructured":"Enteric dysbiosis promotes antibiotic-resistant bacterial infection: Systemic dissemination of resistant and commensal bacteria through epithelial transcytosis. 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