{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T08:37:10Z","timestamp":1786523830783,"version":"build-2736575974"},"reference-count":139,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases\u2014National Science and Technology Major Project","award":["2024ZD0529004"],"award-info":[{"award-number":["2024ZD0529004"]}]},{"name":"Prevention and Control of Emerging and Major Infectious Diseases\u2014National Science and Technology Major Project","award":["2025ZD01902600"],"award-info":[{"award-number":["2025ZD01902600"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472223"],"award-info":[{"award-number":["82472223"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82472223"],"award-info":[{"award-number":["82472223"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The oral and gut microbiomes form an interconnected ecosystem that may influence host defense. In the intensive care unit (ICU), endotracheal intubation, broad-spectrum antibiotics, and proton pump inhibitors can disrupt physiological barriers and may facilitate ectopic gut colonization by oral pathobionts. Such translocation could contribute to intestinal inflammation, barrier dysfunction, and systemic immune dysregulation; however, direct clinical evidence in critically ill patients remains limited and largely associative, and much of the mechanistic evidence derives from animal models or non-ICU populations. This hypothesis-generating narrative review synthesizes evidence across oral microbiology, gastroenterology, immunology, and critical care, while explicitly distinguishing clinically observed associations from preclinical mechanisms and proposed ICU pathways. Current evidence supports mechanical toothbrushing as a core component of oral care, whereas routine non-selective chlorhexidine use warrants caution. Saline irrigation and selective oropharyngeal decontamination may be considered in context, but evidence for protecting the gut through oral care remains insufficient for definitive practice recommendations. We also examine probiotics, prebiotics, postbiotics, and fecal microbiota transplantation as investigational approaches and propose standardized prospective multicenter studies to test the oral\u2013gut axis framework.<\/jats:p>","DOI":"10.3390\/microorganisms14081772","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:57:26Z","timestamp":1786521446000},"page":"1772","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Lungs: ICU Oral Care and Gut Resilience\u2014A Hypothesis-Generating Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Tingting","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China"},{"name":"Key Laboratory of Anesthesiology and Resuscitation, Huazhong University of Science and Technology, Ministry of Education, Wuhan 430048, China"},{"name":"Hubei JiangXia Laboratory, Wuhan 430200, China"},{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Shihezi University, Shihezi 832008, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqiang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China"},{"name":"Key Laboratory of Anesthesiology and Resuscitation, Huazhong University of Science and Technology, Ministry of Education, Wuhan 430048, China"},{"name":"Hubei JiangXia Laboratory, Wuhan 430200, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China"},{"name":"Key Laboratory of Anesthesiology and Resuscitation, Huazhong University of Science and Technology, Ministry of Education, Wuhan 430048, China"},{"name":"Hubei JiangXia Laboratory, Wuhan 430200, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2820-0851","authenticated-orcid":false,"given":"Jiancheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China"},{"name":"Key Laboratory of Anesthesiology and Resuscitation, Huazhong University of Science and Technology, Ministry of Education, Wuhan 430048, China"},{"name":"Hubei JiangXia Laboratory, Wuhan 430200, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1373208","DOI":"10.1080\/21688370.2017.1373208","article-title":"Intestinal barrier and gut microbiota: Shaping our immune responses throughout life","volume":"5","author":"Takiishi","year":"2017","journal-title":"Tissue Barriers"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Leonov, G., Salikhova, D., Starodubova, A., Vasilyev, A., Makhnach, O., Fatkhudinov, T., and Goldshtein, D. (2024). Oral microbiome dysbiosis as a risk factor for stroke: A comprehensive review. Microorganisms, 12.","DOI":"10.3390\/microorganisms12081732"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41522-025-00646-5","article-title":"The oral-gut microbiota axis: A link in cardiometabolic diseases","volume":"11","author":"Xu","year":"2025","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e70107","DOI":"10.1111\/aji.70107","article-title":"Oral microbiome and adverse pregnancy outcomes","volume":"93","author":"Dodson","year":"2025","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2506843","DOI":"10.1080\/19490976.2025.2506843","article-title":"Microbiome signatures of virulence in the oral-gut-brain axis influence Parkinson\u2019s disease and cognitive decline pathophysiology","volume":"17","author":"Clasen","year":"2025","journal-title":"Gut Microbes"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"967","DOI":"10.3748\/wjg.v29.i6.967","article-title":"Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis","volume":"29","author":"Kuraji","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"BSR20220583","DOI":"10.1042\/BSR20220583","article-title":"A potential oral microbiome signature associated with coronary artery disease in Tunisia","volume":"42","author":"Bouzid","year":"2022","journal-title":"Biosci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/prd.12385","article-title":"Periodontitis and rheumatoid arthritis: What have we learned about their connection and their treatment?","volume":"87","author":"Sanz","year":"2021","journal-title":"Periodontology 2000"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/nri3785","article-title":"Periodontitis: From microbial immune subversion to systemic inflammation","volume":"15","author":"Hajishengallis","year":"2015","journal-title":"Nat. Rev. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1038\/s41577-020-00488-6","article-title":"Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities","volume":"21","author":"Hajishengallis","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4708","DOI":"10.1038\/s41467-024-48819-8","article-title":"Longitudinal multicompartment characterization of host-microbiota interactions in patients with acute respiratory failure","volume":"15","author":"Kitsios","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"R189","DOI":"10.1186\/cc12878","article-title":"Changes in dental plaque following hospitalisation in a critical care unit: An observational study","volume":"17","author":"Sachdev","year":"2013","journal-title":"Crit. Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1177\/00220345850640101101","article-title":"The effect of swallowing frequency on oral sugar clearance and pH changes by Streptococcus mitior in vivo after sucrose ingestion","volume":"64","author":"Dawes","year":"1985","journal-title":"J. Dent. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1099\/jmm.0.041699-0","article-title":"Inhibition of Candida albicans yeast-hyphal transition and biofilm formation by Solidago virgaurea water extracts","volume":"61","author":"Chevalier","year":"2012","journal-title":"J. Med. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s13054-025-05576-4","article-title":"Oral care for intubated patients in the intensive care unit: Examination of bacterial count and microbiota","volume":"29","author":"Kanamori","year":"2025","journal-title":"Crit. Care"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Shi, T., Wang, J., Dong, J., Hu, P., and Guo, Q. (2023). Periodontopathogens Porphyromonas gingivalis and Fusobacterium nucleatum and their roles in the progression of respiratory diseases. Pathogens, 12.","DOI":"10.3390\/pathogens12091110"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.3390\/microorganisms10091868","article-title":"Insight into the relationship between oral microbiota and the inflammatory bowel disease","volume":"10","author":"Han","year":"2022","journal-title":"Microorganisms"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/s41586-021-03986-2","article-title":"Unravelling the collateral damage of antibiotics on gut bacteria","volume":"599","author":"Maier","year":"2021","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1038\/s41579-023-00933-y","article-title":"Antibiotic perturbations to the gut microbiome","volume":"21","author":"Fishbein","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1038\/s41564-024-01680-3","article-title":"Oral bacteria relative abundance in faeces increases due to gut microbiota depletion and is linked with patient outcomes","volume":"9","author":"Liao","year":"2024","journal-title":"Nat. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102147","DOI":"10.1016\/j.mib.2022.102147","article-title":"Deciphering mechanisms and implications of bacterial translocation in human health and disease","volume":"67","author":"Jin","year":"2022","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1126\/science.aan4526","article-title":"Ectopic colonization of oral bacteria in the intestine drives T(H)1 cell induction and inflammation","volume":"358","author":"Atarashi","year":"2017","journal-title":"Science"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e40553","DOI":"10.7554\/eLife.40553","article-title":"Gut microbiota density influences host physiology and is shaped by host and microbial factors","volume":"8","author":"Contijoch","year":"2019","journal-title":"eLife"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"21536","DOI":"10.1073\/pnas.1922189117","article-title":"Defined microbiota transplant restores Th17\/ROR\u03b3t+ regulatory T cell balance in mice colonized with inflammatory bowel disease microbiotas","volume":"117","author":"Britton","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1038\/s41467-024-45473-y","article-title":"Porphyromonas gingivalis aggravates colitis via a gut microbiota-linoleic acid metabolism-Th17\/Treg cell balance axis","volume":"15","author":"Jia","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1038\/s41591-022-01913-0","article-title":"Drivers and determinants of strain dynamics following fecal microbiota transplantation","volume":"28","author":"Schmidt","year":"2022","journal-title":"Nat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e230470","DOI":"10.1001\/jamanetworkopen.2023.0470","article-title":"Association of proton pump inhibitor use with risk of acquiring drug-resistant Enterobacterales","volume":"6","author":"Willems","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/apt.12069","article-title":"Proton pump inhibitor therapy predisposes to community-acquired Streptococcus pneumoniae pneumonia","volume":"36","author":"Wever","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/bcpt.13023","article-title":"Side effects of long-term proton pump inhibitor use: A review","volume":"123","author":"Haastrup","year":"2018","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1038\/s41467-018-05184-7","article-title":"Gut microbiota associations with common diseases and prescription medications in a population-based cohort","volume":"9","author":"Jackson","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1136\/gutjnl-2015-310376","article-title":"Proton pump inhibitors affect the gut microbiome","volume":"65","author":"Imhann","year":"2016","journal-title":"Gut"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1038\/s41586-021-04177-9","article-title":"Combinatorial, additive and dose-dependent drug-microbiome associations","volume":"600","author":"Forslund","year":"2021","journal-title":"Nature"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1053\/j.gastro.2022.06.070","article-title":"Population-level metagenomics uncovers distinct effects of multiple medications on the human gut microbiome","volume":"163","author":"Nagata","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1038\/s41467-019-14177-z","article-title":"Impact of commonly used drugs on the composition and metabolic function of the gut microbiota","volume":"11","author":"Collij","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1136\/gutjnl-2023-330168","article-title":"Compared to histamine-2 receptor antagonist, proton pump inhibitor induces stronger oral-to-gut microbial transmission and gut microbiome alterations: A randomised controlled trial","volume":"73","author":"Zhu","year":"2024","journal-title":"Gut"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11894-024-00954-4","article-title":"The gut in critical illness","volume":"27","author":"Patel","year":"2025","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/s41569-022-00737-2","article-title":"Gut-derived low-grade endotoxaemia, atherothrombosis and cardiovascular disease","volume":"20","author":"Violi","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/s13054-022-04127-5","article-title":"The central and biodynamic role of gut microbiota in critically ill patients","volume":"26","author":"Wozniak","year":"2022","journal-title":"Crit. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6737","DOI":"10.1038\/s41467-024-51209-9","article-title":"Gut-derived memory \u03b3\u03b4 T17 cells exacerbate sepsis-induced acute lung injury in mice","volume":"15","author":"Xie","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"6779","DOI":"10.1038\/s41467-025-62181-3","article-title":"Small intestinal \u03b3\u03b4 T17 cells promote SAE through STING\/C1q-induced microglial synaptic pruning in male mice","volume":"16","author":"Wu","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2351478","DOI":"10.1080\/19490976.2024.2351478","article-title":"Pathogenesis and therapeutic opportunities of gut microbiome dysbiosis in critical illness","volume":"16","author":"Cho","year":"2024","journal-title":"Gut Microbes"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1136\/gutjnl-2024-333378","article-title":"What defines a healthy gut microbiome?","volume":"73","author":"Cani","year":"2024","journal-title":"Gut"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1038\/s41422-020-0332-7","article-title":"Interaction between microbiota and immunity in health and disease","volume":"30","author":"Zheng","year":"2020","journal-title":"Cell Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/s41579-020-0433-9","article-title":"Gut microbiota in human metabolic health and disease","volume":"19","author":"Fan","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and diseases","volume":"7","author":"Hou","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1002\/mlf2.12136","article-title":"Oral microbiome in human health and diseases","volume":"3","author":"Tian","year":"2024","journal-title":"mLife"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Willis, J.R., and Gabald\u00f3n, T. (2020). The human oral microbiome in health and disease: From sequences to ecosystems. Microorganisms, 8.","DOI":"10.3390\/microorganisms8020308"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1038\/s41579-023-00963-6","article-title":"The oral microbiome: Diversity, biogeography and human health","volume":"22","author":"Baker","year":"2024","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1177\/0022034520924633","article-title":"The bacterial connection between the oral cavity and the gut diseases","volume":"99","author":"Kitamoto","year":"2020","journal-title":"J. Dent. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.micpath.2015.09.009","article-title":"Periodontal-disease-associated biofilm: A reservoir for pathogens of medical importance","volume":"94","author":"Hartenbach","year":"2016","journal-title":"Microb. Pathog."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e281422","DOI":"10.1128\/spectrum.02814-22","article-title":"Extent of oral-gut transmission of bacterial and fungal microbiota in healthy Chinese adults","volume":"11","author":"Cheung","year":"2023","journal-title":"Microbiol. Spectr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/s41597-024-02916-x","article-title":"Multi-cohort shotgun metagenomic analysis of oral and gut microbiota overlap in healthy adults","volume":"11","author":"Rashidi","year":"2024","journal-title":"Sci. Data"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1038\/s41577-024-01057-x","article-title":"How bile acids and the microbiota interact to shape host immunity","volume":"24","author":"Lee","year":"2024","journal-title":"Nat. Rev. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S2468-1253(24)00390-X","article-title":"The intestinal barrier: A pivotal role in health, inflammation, and cancer","volume":"10","author":"Neurath","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.chom.2024.05.002","article-title":"Intestinal colonization resistance in the context of environmental, host, and microbial determinants","volume":"32","author":"Woelfel","year":"2024","journal-title":"Cell Host Microbe"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1038\/s41579-025-01163-0","article-title":"Microbiota in inflammatory bowel disease: Mechanisms of disease and therapeutic opportunities","volume":"23","author":"Iliev","year":"2025","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e2114152118","DOI":"10.1073\/pnas.2114152118","article-title":"No evidence for colonization of oral bacteria in the distal gut in healthy adults","volume":"118","author":"Rashidi","year":"2021","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e42693","DOI":"10.7554\/eLife.42693","article-title":"Extensive transmission of microbes along the gastrointestinal tract","volume":"8","author":"Schmidt","year":"2019","journal-title":"eLife"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"K\u00f6n\u00f6nen, E., and Gursoy, U.K. (2022). Oral Prevotella species and their connection to events of clinical relevance in gastrointestinal and respiratory tracts. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.798763"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41368-022-00183-3","article-title":"Periodontitis may induce gut microbiota dysbiosis via salivary microbiota","volume":"14","author":"Bao","year":"2022","journal-title":"Int. J. Oral Sci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1038\/s41579-024-01075-5","article-title":"The oral-gut microbiome axis in health and disease","volume":"22","author":"Kunath","year":"2024","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1016\/j.chom.2025.07.019","article-title":"Veillonella intestinal colonization promotes C. difficile infection in Crohn\u2019s disease","volume":"33","author":"Yang","year":"2025","journal-title":"Cell Host Microbe"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"116374","DOI":"10.1016\/j.celrep.2025.116374","article-title":"Bile acid synthesis dysregulation in liver diseases promotes ectopic expansion of oral streptococci in the intestine","volume":"44","author":"Wang","year":"2025","journal-title":"Cell Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/path.5358","article-title":"Fusobacterium nucleatum facilitates ulcerative colitis through activating IL-17F signaling to NF-\u03baB via the upregulation of CARD3 expression","volume":"250","author":"Chen","year":"2020","journal-title":"J. Pathol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"4828","DOI":"10.1038\/srep04828","article-title":"Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota","volume":"4","author":"Arimatsu","year":"2014","journal-title":"Sci. Rep."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Xiao, L., Huang, L., Zhou, X., Zhao, D., Wang, Y., Min, H., Song, S., Sun, W., Gao, Q., and Hu, Q. (2022). Experimental periodontitis deteriorated atherosclerosis associated with trimethylamine N-oxide metabolism in mice. Front. Cell. Infect. Microbiol., 11, Erratum in Front. Cell. Infect. Microbiol. 2022, 12, 919013.","DOI":"10.3389\/fcimb.2022.919013"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1161\/CIRCRESAHA.115.306301","article-title":"Endothelial cell dysfunction and the pathobiology of atherosclerosis","volume":"118","author":"Gimbrone","year":"2016","journal-title":"Circ. Res."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Zhang, J., Xie, M., Huang, X., Chen, G., Yin, Y., Lu, X., Feng, G., Yu, R., and Chen, L. (2021). The effects of Porphyromonas gingivalis on atherosclerosis-related cells. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.766560"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2073785","DOI":"10.1080\/19490976.2022.2073785","article-title":"Periodontitis pathogen Porphyromonas gingivalis promotes pancreatic tumorigenesis via neutrophil elastase from tumor-associated neutrophils","volume":"14","author":"Tan","year":"2022","journal-title":"Gut Microbes"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1136\/gutjnl-2023-330941","article-title":"Oral bacteria accelerate pancreatic cancer development in mice","volume":"73","author":"Saba","year":"2024","journal-title":"Gut"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1001\/jamaoncol.2025.3377","article-title":"Oral bacterial and fungal microbiome and subsequent risk for pancreatic cancer","volume":"11","author":"Meng","year":"2025","journal-title":"JAMA Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"jjae162","DOI":"10.1093\/ecco-jcc\/jjae162","article-title":"The bidirectional effects of periodontal disease and oral dysbiosis on gut inflammation in inflammatory bowel disease","volume":"19","author":"Zilberstein","year":"2025","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0378-1097(03)00164-2","article-title":"Acid tolerance response of biofilm cells of Streptococcus mutans","volume":"221","author":"McNeill","year":"2003","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1399-302X.1997.tb00733.x","article-title":"Acid tolerance and acid-neutralizing activity of Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum","volume":"12","author":"Takahashi","year":"1997","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1038\/s41564-022-01224-7","article-title":"Inflammation-associated nitrate facilitates ectopic colonization of oral bacterium Veillonella parvula in the intestine","volume":"7","author":"Brown","year":"2022","journal-title":"Nat. Microbiol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Azzolino, D., Carnevale-Schianca, M., Santacroce, L., Colella, M., Felicetti, A., Terranova, L., Castrej\u00f3n-P\u00e9rez, R.C., Garcia-Godoy, F., Lucchi, T., and Passarelli, P.C. (2025). The oral-gut microbiota axis across the lifespan: New insights on a forgotten interaction. Nutrients, 17.","DOI":"10.3390\/nu17152538"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.cell.2020.05.048","article-title":"The intermucosal connection between the mouth and gut in commensal pathobiont-driven colitis","volume":"182","author":"Kitamoto","year":"2020","journal-title":"Cell"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"6696","DOI":"10.1073\/pnas.1405634111","article-title":"Endoscopic photoconversion reveals unexpectedly broad leukocyte trafficking to and from the gut","volume":"111","author":"Morton","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/prd.12424","article-title":"Periodontal connection with intestinal inflammation: Microbiological and immunological mechanisms","volume":"89","author":"Kitamoto","year":"2022","journal-title":"Periodontol. 2000"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"7061","DOI":"10.1073\/pnas.1415675112","article-title":"Th17 cells give rise to Th1 cells that are required for the pathogenesis of colitis","volume":"112","author":"Harbour","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.immuni.2010.08.010","article-title":"Interleukin-23 drives intestinal inflammation through direct activity on T cells","volume":"33","author":"Ahern","year":"2010","journal-title":"Immunity"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1987780","DOI":"10.1080\/19490976.2021.1987780","article-title":"Fusobacterium nucleatum drives a pro-inflammatory intestinal microenvironment through metabolite receptor-dependent modulation of IL-17 expression","volume":"13","author":"Brennan","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"111314","DOI":"10.1016\/j.celrep.2022.111314","article-title":"Pathobiont-responsive Th17 cells in gut-mouth axis provoke inflammatory oral disease and are modulated by intestinal microbiome","volume":"40","author":"Nagao","year":"2022","journal-title":"Cell Rep."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e280","DOI":"10.1093\/infdis\/jiaf278","article-title":"Prevotella intermedia synergistically exacerbates pneumonia induced by oral streptococci","volume":"232","author":"Ashizawa","year":"2025","journal-title":"J. Infect. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1111\/jocn.15014","article-title":"Exploration of difficulty accessing the mouths of intubated and mechanically ventilated adults for oral care: A video and photographic elicitation study","volume":"29","author":"Dale","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1177\/00220345890680050101","article-title":"Bacterial adhesion to oral tissues: A model for infectious diseases","volume":"68","author":"Gibbons","year":"1989","journal-title":"J. Dent. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"107S","DOI":"10.1016\/0003-9969(90)90139-2","article-title":"Role of cryptic receptors (cryptitopes) in bacterial adhesion to oral surfaces","volume":"35","author":"Gibbons","year":"1990","journal-title":"Arch. Oral Biol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1099\/jmm.0.055830-0","article-title":"Quantitative detection of Staphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa in human oral epithelial cells from subjects with periodontitis and periodontal health","volume":"62","author":"Colombo","year":"2013","journal-title":"J. Med. Microbiol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1164\/rccm.201912-2441OC","article-title":"Respiratory tract dysbiosis is associated with worse outcomes in mechanically ventilated patients","volume":"202","author":"Kitsios","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/08850666251320924","article-title":"Association of number of oral bacteria with ventilator-associated pneumonia and delirium in patients in the intensive care unit","volume":"40","author":"Arimizu","year":"2025","journal-title":"J. Intensive Care Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.archger.2006.04.004","article-title":"Colonization of dental plaque by respiratory pathogens in dependent elderly","volume":"44","author":"Sumi","year":"2007","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1574-695X.2010.00709.x","article-title":"Opportunistic respiratory pathogens in the oral cavity of the elderly","volume":"60","author":"Tada","year":"2010","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"27179","DOI":"10.1038\/s41598-024-78102-1","article-title":"Comparative analysis of the postadmission and antemortem oropharyngeal and rectal swab microbiota of ICU patients","volume":"14","author":"Petrilla","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Zhang, X., Li, Q., Xia, S., He, Y., Liu, Y., Yang, J., and Xiao, X. (2024). Proton pump inhibitors and oral-gut microbiota: From mechanism to clinical significance. Biomedicines, 12.","DOI":"10.3390\/biomedicines12102271"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1600-051X.2010.01664.x","article-title":"Antimicrobial peptides and periodontal disease","volume":"38","author":"Gorr","year":"2011","journal-title":"J. Clin. Periodontol."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Stoian, M., Andone, A., Boeriu, A., B\u00e2ndil\u0103, S.R., Dobru, D., Laszlo, S.\u0218., Cor\u0103u, D., Arb\u0103na\u0219i, E.M., Russu, E., and Stoian, A. (2024). COVID-19 and Clostridioides difficile coinfection analysis in the intensive care unit. Antibiotics, 13.","DOI":"10.3390\/antibiotics13040367"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"e70095","DOI":"10.1111\/nicc.70095","article-title":"Oral care practices, attitudes and challenges faced by intensive care unit nurses in the care of intubated patients: A descriptive study","volume":"30","author":"Aktan","year":"2025","journal-title":"Nurs. Crit. Care"},{"key":"ref_98","first-page":"2126021225","article-title":"Knowledge, attitudes, and practices of intensive care unit nurses regarding oral care for intubated patients in Hebron hospitals, Palestine","volume":"11","author":"Alqaissi","year":"2025","journal-title":"SAGE Open Nurs."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/idh.12822","article-title":"Oral care practices for patients in intensive care unit: A systematic review","volume":"23","author":"Silva","year":"2025","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jgar.2016.12.007","article-title":"Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine","volume":"8","author":"Tuon","year":"2017","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jcrc.2016.07.019","article-title":"Respiratory pathogen colonization of dental plaque, the lower airways, and endotracheal tube biofilms during mechanical ventilation","volume":"37","author":"Sands","year":"2017","journal-title":"J. Crit. Care"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1128\/JCM.01963-06","article-title":"Molecular analysis of oral and respiratory bacterial species associated with ventilator-associated pneumonia","volume":"45","author":"Paster","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"443","DOI":"10.4037\/ajcc2021528","article-title":"Pepsin A in tracheal secretions from patients receiving mechanical ventilation","volume":"30","author":"Talbert","year":"2021","journal-title":"Am. J. Crit. Care"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1007\/s00134-017-4736-x","article-title":"Impact of tapered-cuff tracheal tube on microaspiration of gastric contents in intubated critically ill patients: A multicenter cluster-randomized cross-over controlled trial","volume":"43","author":"Jaillette","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1086\/593193","article-title":"Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation","volume":"47","author":"Heo","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/j.2041-1014.2011.00622.x","article-title":"Community-based interference against integration of Pseudomonas aeruginosa into human salivary microbial biofilm","volume":"26","author":"He","year":"2011","journal-title":"Mol. Oral Microbiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"430","DOI":"10.4066\/AMJ.2013.1710","article-title":"Aetiological agents of ventilator-associated pneumonia and its resistance pattern\u2014A threat for treatment","volume":"6","author":"Charles","year":"2013","journal-title":"Australas. Med. J."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.ajpath.2024.11.009","article-title":"IL-35 may prevent the exacerbation of aspiration pneumonia involving Porphyromonas gingivalis by suppressing IL-17 production","volume":"195","author":"Kawamura","year":"2025","journal-title":"Am. J. Pathol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1111\/j.1532-5415.2008.01825.x","article-title":"Modification of the risk of mortality from pneumonia with oral hygiene care","volume":"56","author":"Bassim","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S0140-6736(05)75550-1","article-title":"Oral care and pneumonia","volume":"354","author":"Yoneyama","year":"1999","journal-title":"Lancet"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1001\/jamainternmed.2014.359","article-title":"Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: Systematic review and meta-analysis","volume":"174","author":"Klompas","year":"2014","journal-title":"JAMA Intern. Med."},{"key":"ref_112","first-page":"CD8367","article-title":"Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia","volume":"12","author":"Zhao","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s44158-024-00166-2","article-title":"Chlorhexidine is not effective at any concentration in preventing ventilator-associated pneumonia: A systematic review and network meta-analysis","volume":"4","author":"Pettenuzzo","year":"2024","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"g2197","DOI":"10.1136\/bmj.g2197","article-title":"Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: Systematic review and network meta-analysis","volume":"348","author":"Price","year":"2014","journal-title":"BMJ"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00134-018-5171-3","article-title":"Effects of chlorhexidine gluconate oral care on hospital mortality: A hospital-wide, observational cohort study","volume":"44","author":"Deschepper","year":"2018","journal-title":"Intensive Care Med."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1001\/jamainternmed.2016.2427","article-title":"Associations between ventilator bundle components and outcomes","volume":"176","author":"Klompas","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1007\/s00134-021-06475-2","article-title":"Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): A multi-center stepped wedge cluster-randomized controlled trial","volume":"47","author":"Dale","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/idh.12560","article-title":"Use of toothbrushing in conjunction with chlorhexidine for preventing ventilator-associated pneumonia: A random-effect meta-analysis of randomized controlled trials","volume":"21","author":"Sozkes","year":"2023","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1007\/s00134-016-4217-7","article-title":"Oral mucosal adverse events with chlorhexidine 2% mouthwash in ICU","volume":"42","author":"Plantinga","year":"2016","journal-title":"Intensive Care Med."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Cieplik, F., Jakubovics, N.S., Buchalla, W., Maisch, T., Hellwig, E., and Al-Ahmad, A. (2019). Resistance toward chlorhexidine in oral bacteria\u2014Is there cause for concern?. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.00587"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jhin.2016.08.018","article-title":"Acquired resistance to chlorhexidine\u2014Is it time to establish an \u2018antiseptic stewardship\u2019 initiative?","volume":"94","author":"Kampf","year":"2016","journal-title":"J. Hosp. Infect."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1001\/jamainternmed.2023.6638","article-title":"Association between daily toothbrushing and hospital-acquired pneumonia: A systematic review and meta-analysis","volume":"184","author":"Ehrenzeller","year":"2024","journal-title":"JAMA Intern. Med."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/s13054-026-05936-8","article-title":"Effectiveness of toothbrushing as a replacement for chlorhexidine in oral care, combined with head elevation for the prevention of ventilator-associated pneumonia in intensive care units: Interrupted time-series analysis","volume":"30","author":"Jo","year":"2026","journal-title":"Crit. Care"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"101095","DOI":"10.1016\/j.aucc.2024.06.014","article-title":"Effect of different mouthwashes on ventilator-related outcomes and mortality in intensive care unit patients: A network meta-analysis","volume":"38","author":"He","year":"2025","journal-title":"Aust. Crit. Care"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4037\/ccn2022672","article-title":"Oral microbes in hospital-acquired pneumonia: Practice and research implications","volume":"42","author":"Rathbun","year":"2022","journal-title":"Crit. Care Nurse"},{"key":"ref_126","first-page":"288","article-title":"Denture biofilm increases respiratory diseases in the elderly. A mini-review","volume":"37","author":"Maciel","year":"2024","journal-title":"Am. J. Dent."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1017\/ice.2022.88","article-title":"Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 update","volume":"43","author":"Klompas","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1056\/NEJMoa0800394","article-title":"Decontamination of the digestive tract and oropharynx in ICU patients","volume":"360","author":"Kluytmans","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.cmi.2017.08.019","article-title":"Selective digestive and oropharyngeal decontamination in medical and surgical ICU patients: Individual patient data meta-analysis","volume":"24","author":"Plantinga","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"The SuDDICU Investigators for the Australia and New Zealand Intensive Care Society Clinical Trials Group, and The Canadian Critical Care Trials Group (2025). Selective decontamination of the digestive tract during ventilation in the ICU. N. Engl. J. Med., 394, 1491\u20131502.","DOI":"10.1056\/NEJMoa2506398"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1001\/jama.2018.13765","article-title":"Decontamination strategies and bloodstream infections with antibiotic-resistant microorganisms in ventilated patients: A randomized clinical trial","volume":"320","author":"Wittekamp","year":"2018","journal-title":"JAMA"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.cmi.2019.08.001","article-title":"The effects of topical antibiotics on eradication and acquisition of third-generation cephalosporin and carbapenem-resistant Gram-negative bacteria in ICU patients; A post hoc analysis from a multicentre cluster-randomized trial","volume":"26","author":"Plantinga","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s00134-022-06826-7","article-title":"Ecological effects of selective oral decontamination on multidrug-resistance bacteria acquired in the intensive care unit: A case-control study over 5 years","volume":"48","author":"Wang","year":"2022","journal-title":"Intensive Care Med."},{"key":"ref_134","doi-asserted-by":"crossref","unstructured":"Qiu, C., Tang, L., Hang, Z., Wei, K., Wang, S., Zhu, X., and Wang, Q. (2025). Effect of chlorhexidine vs. saline for oral care on oral microbiota and prognosis of elderly mechanically ventilated patients in the intensive care unit: A single-center, single-blind, randomized controlled trial. BMC Oral Health, 26.","DOI":"10.1186\/s12903-025-07579-7"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s40560-025-00786-y","article-title":"Gut integrity in intensive care: Alterations in host permeability and the microbiome as potential therapeutic targets","volume":"13","author":"Oami","year":"2025","journal-title":"J. Intensive Care"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.ccc.2024.11.002","article-title":"Recent insights into the evolving role of the gut microbiome in critical care","volume":"41","author":"Lee","year":"2025","journal-title":"Crit. Care Clin."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.jointm.2023.11.006","article-title":"Genetic causal association between gut microbiota and sepsis: Evidence from a two-sample bidirectional Mendelian randomization analysis","volume":"4","author":"Tang","year":"2024","journal-title":"J. Intensive Med."},{"key":"ref_138","doi-asserted-by":"crossref","unstructured":"Mostafavi, S., Nohesara, S., Pirani, A., Mostafavi Abdolmaleky, H., and Thiagalingam, S. (2025). Oral-gut microbiota crosstalk and epigenetic targets in metabolic and neuropsychiatric diseases. Nutrients, 17.","DOI":"10.3390\/nu17213367"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.ajoms.2025.11.011","article-title":"Sex differences of oral-gut microbiota in acutely ill patients","volume":"38","author":"Mano","year":"2025","journal-title":"J. Oral Maxillofac. Surg. Med. 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