{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:37:31Z","timestamp":1788503851088,"version":"build-2803163510"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative infection remains a major cause of morbidity after liver transplantation (LT) in patients with liver failure. Increasing evidence suggests that gut microbiota dysbiosis may contribute to infection risk, but its dynamic changes after LT are not fully understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 60 patients with liver failure who underwent LT and developed postoperative infection-related risk. Patients were divided into a probiotic group and a non-probiotic group. Fecal samples were collected before transplantation and on postoperative days 7, 14, 21, and 28. Metagenomic sequencing was performed to analyze gut microbial composition, diversity, and antibiotic resistance genes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The probiotic group showed a significantly lower rate of postoperative bacterial infection, especially intra-abdominal infection. After LT, gut microbiota gradually recovered in both groups, but restoration was faster in the probiotic group. The non-probiotic group showed persistent dysbiosis, characterized by enrichment of opportunistic pathogens such as\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      , whereas beneficial genera including\n                      <jats:italic>Bifidobacterium<\/jats:italic>\n                      and\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      were more abundant in the probiotic group. Antibiotic resistance genes were also more enriched in the non-probiotic group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early postoperative gut microbiota reconstruction is closely associated with infectious complications after LT, and modulation of gut microbiota may help improve postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1845273","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:10:37Z","timestamp":1780899037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Gut microbiota reconstruction after liver transplantation and its association with early postoperative infections in patients with liver failure"],"prefix":"10.3389","volume":"16","author":[{"given":"Bing","family":"Chen","sequence":"first","affiliation":[{"name":"Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Second People\u2019s Hospital of Guizhou Province","place":["Guiyang, Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangpeng","family":"Feng","sequence":"additional","affiliation":[{"name":"Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University","place":["Hangzhou, China"]},{"name":"School of Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbei","family":"Lv","sequence":"additional","affiliation":[{"name":"Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University","place":["Hangzhou, China"]},{"name":"School of Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghong","family":"Lin","sequence":"additional","affiliation":[{"name":"Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University","place":["Hangzhou, China"]},{"name":"School of Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Jiang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3569","DOI":"10.3390\/nu15163569","article-title":"Gut microbiota and critically ill patients: immunity and its modulation via probiotics and immunonutrition","volume":"15","author":"Abenavoli","year":"2023","journal-title":"Nutrients"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.00376-21","article-title":"The interplay between gut microbiota and the immune system in liver transplant recipients and its role in infections","volume":"89","author":"Ancona","year":"2021","journal-title":"Infect. Immun."},{"key":"B3","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.ajt.2024.02.001","article-title":"Immunopathogenesis of acute on chronic liver failure","volume":"24","author":"Artru","year":"2024","journal-title":"Am. J. Transplant: Off. J. Am. Soc. Transplant. Am. Soc. Transplant Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1053\/j.gastro.2010.06.019","article-title":"Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis","volume":"139","author":"Arvaniti","year":"2010","journal-title":"Gastroenterology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.14309\/ajg.0000000000001595","article-title":"Acute-on-chronic liver failure clinical guidelines","volume":"117","author":"Bajaj","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2023.105444","article-title":"Insights into the genetic contexts of sulfonamide resistance among early clinical isolates of Acinetobacter baumannii","volume":"112","author":"Bala","year":"2023","journal-title":"Infect Genet. Evol: J. Mol. Epidemiol. Evol Genet. Infect. Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.cld.2023.03.006","article-title":"Viral hepatitis and acute-on-chronic liver failure","volume":"27","author":"Bhatti","year":"2023","journal-title":"Clinics Liver Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"670","DOI":"10.3350\/cmh.2022.0103","article-title":"Acute-on-chronic liver failure: terminology, mechanisms and management","volume":"29","author":"Br","year":"2023","journal-title":"Clin. Mol. Hepatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"G413","DOI":"10.1152\/ajpgi.00361.2016","article-title":"Gut-liver axis at the frontier of host-microbial interactions","volume":"312","author":"Brandl","year":"2017","journal-title":"Am. J. Physiol. Gastrointes Liver Physiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4291\/wjgp.v6.i4.99","article-title":"Starring role of toll-like receptor-4 activation in the gut-liver axis","volume":"6","author":"Carotti","year":"2015","journal-title":"World J. Gastrointes Pathophysiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13589","article-title":"Rates and causative pathogens of surgical site infections attributed to liver transplant procedures and other hepatic, biliary, or pancreatic procedures, 2015-2018","volume":"23","author":"Chea","year":"2021","journal-title":"Transplant Infect. Disease: An Off. J. Transplant. Soc."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13843","article-title":"Infectious complications in acute graft-versus-host disease after liver transplantation","volume":"24","author":"Chesdachai","year":"2022","journal-title":"Transpl Infect Dis."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1120515","article-title":"Association between gut microbiota and hepatocellular carcinoma from 2011 to 2022: bibliometric analysis and global trends","volume":"13","author":"Chen","year":"2023","journal-title":"Front. Oncol."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2021.105206","article-title":"Strict relationship between class 1 integrons and resistance to sulfamethoxazole in Escherichia coli","volume":"161","author":"de Los Santos","year":"2021","journal-title":"Microb. Pathogen"},{"key":"B15","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s11739-023-03374-w","article-title":"Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review","volume":"19","author":"Di Vincenzo","year":"2024","journal-title":"Internal Emergency Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1016\/j.jss.2013.03.008","article-title":"Liver transplantation in acute-on-chronic liver failure patients with high model for end-stage liver disease (MELD) scores: a single center experience of 100 consecutive cases","volume":"183","author":"Duan","year":"2013","journal-title":"J. Surg. Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1080\/10408398.2020.1843396","article-title":"Antibiotic-induced gut dysbiosis and barrier disruption and the potential protective strategies","volume":"62","author":"Duan","year":"2022","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.jhep.2024.07.032","article-title":"EASL clinical practice guidelines on liver transplantation","volume":"81","year":"2024","journal-title":"J. Hepatol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1136\/gutjnl-2020-321747","article-title":"Gut microbiome stability and resilience: elucidating the response to perturbations in order to modulate gut health","volume":"70","author":"Fassarella","year":"2021","journal-title":"Gut"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1698937","article-title":"Post-liver transplantation bacterial infection: current status, prevention and treatment","volume":"15","author":"Guo","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.jmii.2023.10.012","article-title":"Genomic epidemiology of hypervirulent carbapenem-resistant Klebsiella pneumoniae at Jinshan local hospital, Shanghai, during 2014-2018","volume":"57","author":"Guo","year":"2024","journal-title":"J. Microbiol Immunol Infect = Wei Mian Yu Gan Ran Za Zhi"},{"key":"B22","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.jhep.2023.05.028","article-title":"The novel SALT-M score predicts 1-year post-transplant mortality in patients with severe acute-on-chronic liver failure","volume":"79","author":"Hernaez","year":"2023","journal-title":"J. Hepatol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"8787","DOI":"10.3748\/wjg.v21.i29.8787","article-title":"Role of the normal gut microbiota","volume":"21","author":"Jandhyala","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1016\/j.cld.2023.03.009","article-title":"Acute on chronic liver failure in patients with alcohol-associated hepatitis: a review","volume":"27","author":"Kezer","year":"2023","journal-title":"Clinics Liver Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/imr.12563","article-title":"The intestinal microbiota: antibiotics, colonization resistance, and enteric pathogens","volume":"279","author":"Kim","year":"2017","journal-title":"Immunol. Rev."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1016\/j.ajt.2024.07.012","article-title":"Liver transplantation for acute liver failure and acute-on-chronic liver failure","volume":"24","author":"Kulkarni","year":"2024","journal-title":"Am. J. Transplant: Off. J. Am. Soc. Transplant. Am. Soc. Transplant Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"S193","DOI":"10.1016\/j.ajt.2025.01.022","article-title":"OPTN\/SRTR 2023 annual data report: liver","volume":"25","author":"Kwong","year":"2025","journal-title":"Am. J. Transplant: Off. J. Am. Soc. Transplant. Am. Soc. Transplant Surg"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100638","article-title":"Predicting the survival benefit of liver transplantation in HBV-related acute-on-chronic liver failure: an observational cohort study","volume":"32","author":"Li","year":"2023","journal-title":"Lancet Region Health West Pac"},{"key":"B29","doi-asserted-by":"publisher","first-page":"798","DOI":"10.3904\/kjim.2017.230","article-title":"Predictors of postoperative infectious complications in liver transplant recipients: experience of 185 consecutive cases","volume":"33","author":"Lim","year":"2018","journal-title":"Kor J. Internal Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.21037\/amj.2017.12.10","article-title":"Infectious complications of liver transplantation","author":"Lin","year":"2018"},{"key":"B31","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13073-016-0307-y","article-title":"The healthy human microbiome","volume":"8","author":"Lloyd-Price","year":"2016","journal-title":"Genome Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1038\/nature11550","article-title":"Diversity, stability and resilience of the human gut microbiota","volume":"489","author":"Lozupone","year":"2012","journal-title":"Nature"},{"key":"B33","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1093\/jac\/44.1.19","article-title":"A variety of gram-positive bacteria carry mobile mef genes","volume":"44","author":"Luna","year":"1999","journal-title":"J. Antimicrob. Chemother."},{"key":"B34","doi-asserted-by":"publisher","first-page":"326","DOI":"10.34172\/aim.2020.22","article-title":"Post liver transplantation survival and related prognostic factors among adult recipients in Tehran Liver Transplant Center; 2002-2019","volume":"23","author":"Madreseh","year":"2020","journal-title":"Arch. Iran Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1055\/s-0042-1742423","article-title":"Molecular characterization of high-level aminoglycoside resistance among Enterococcus species","volume":"14","author":"Manoharan","year":"2022","journal-title":"J. Lab. Phys"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1128\/aac.42.9.2215","article-title":"Glycopeptide antibiotic resistance genes in glycopeptide-producing organisms","volume":"42","author":"Marshall","year":"1998","journal-title":"Antimicrob. Agents Chemother."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e297","DOI":"10.1097\/tp.0000000000002810","article-title":"Prediction of perioperative mortality of cadaveric liver transplant recipients during their evaluations","volume":"103","author":"Molinari","year":"2019","journal-title":"Transplantation"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1111\/ajt.14198","article-title":"Adult living donor liver transplantation for acute-on-chronic liver failure in high-model for end-stage liver disease score patients","volume":"17","author":"Moon","year":"2017","journal-title":"Am. J. Transplant: Off. J. Am. Soc. Transplant. Am. Soc. Transplant Surg"},{"key":"B39","doi-asserted-by":"publisher","first-page":"2802","DOI":"10.1038\/s41467-018-05249-7","article-title":"Bilophila wadsworthia aggravates high fat diet induced metabolic dysfunctions in mice","volume":"9","author":"Natividad","year":"2018","journal-title":"Nat. Commun."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2025.116369","article-title":"The bidirectional interplay between gut dysbiosis and surgical complications: a systematic review","volume":"245","author":"Nichols","year":"2025","journal-title":"Am. J. Surg."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8020269","article-title":"Gut microbiota, antibiotic therapy and antimicrobial resistance: a narrative review","volume":"8","author":"Pilmis","year":"2020","journal-title":"Microorganisms"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2013.00121","article-title":"Rise and dissemination of aminoglycoside resistance: the aac(6')-Ib paradigm","volume":"4","author":"Ramirez","year":"2013","journal-title":"Front. Microbiol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3390\/microorganisms7010014","article-title":"What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases","volume":"7","author":"Rinninella","year":"2019","journal-title":"Microorganisms"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00394-017-1445-8","article-title":"Gut microbiota functions: metabolism of nutrients and other food components","volume":"57","author":"Rowland","year":"2018","journal-title":"Eur. J. Nutr."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3390\/nu13072439","article-title":"Gut microbiota and probiotics\/synbiotics for modulation of immunity in critically ill patients","volume":"13","author":"Shimizu","year":"2021","journal-title":"Nutrients"},{"key":"B46","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1097\/hep.0000000000000344","article-title":"Gut microbiome-brain-cirrhosis axis","volume":"80","author":"Smith","year":"2024","journal-title":"Hepatol. Baltimore Md"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.3390\/pathogens12091094","article-title":"Effect of artificial liver support systems on gut microbiota in patients with HBV-related acute-on-chronic liver failure","volume":"12","author":"Song","year":"2023","journal-title":"Pathog. Basl Switz"},{"key":"B48","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1016\/j.ajt.2023.05.030","article-title":"Impact of gut microbiota on liver transplantation","volume":"23","author":"Sucu","year":"2023","journal-title":"Am. J. Transplant."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.1007\/s00134-025-08106-6","article-title":"Antibiotics with anaerobic coverage are associated with disproportionate gut microbiota disruption in ICU patients: a multi-centre, longitudinal observational study","volume":"51","author":"Taylor","year":"2025","journal-title":"Intensive Care Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1038\/s41575-018-0011-z","article-title":"The gut-liver axis and the intersection with the microbiome","volume":"15","author":"Tripathi","year":"2018","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v32.i3.112437","article-title":"Interplay between viral infections and gut microbiota dysbiosis: mechanisms and therapeutic potential","volume":"32","author":"Velikova","year":"2026","journal-title":"World J. Gastroenterol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"369","DOI":"10.21037\/atm-20-5618","article-title":"In-hospital mortality of liver transplantation and risk factors: a single-center experience","author":"Zhang","year":"2021"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1845273\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T06:10:39Z","timestamp":1780899039000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1845273\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":52,"alternative-id":["10.3389\/fcimb.2026.1845273"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1845273","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"article-number":"1845273"}}