ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Intestinal Dysbiosis in Critically Ill Patients: A Case-Control Study of Enterobacteriaceae Enrichment and Reduced Microbial Diversity
Provisionally accepted
- 河北医科大学第一医院, 石家庄, China
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Introduction: Critical illness disrupts gut microbiota homeostasis, potentially exacerbating systemic inflammation and adverse outcomes. This study investigates gut dysbiosis patterns in ICU patients, with a focus on Enterobacteriaceae enrichment and microbial diversity loss, to identify biomarkers and therapeutic targets.Methods: In this case-control study, 37 ICU patients (sepsis: n=17; non-sepsis: n=20) and 20 healthy controls were enrolled. Fecal samples underwent 16S rRNA sequencing (V3– V4 regions). Microbial diversity (Shannon/Simpson indices), beta diversity (Bray-Curtis PCoA), and taxonomic differences (LEfSe, LDA>2.5) were analyzed using QIIME2 and R.Results: Critically ill patients showed reduced alpha diversity vs. controls (Shannon p=0.04; Simpson p=0.04). Enterobacteriaceae (phylum Proteobacteria) were significantly enriched in ICU patients (LDA=4.2, p<0.01), while Ruminococcus dominated controls. Beta diversity differed markedly (PERMANOVA R²=0.199, p=0.001). No diversity differences were observed between sepsis/non-sepsis subgroups (p>0.05).Conclusion: ICU patients exhibit gut dysbiosis characterized by Enterobacteriaceae expansion and diversity loss, independent of sepsis status. These findings underscore the gut microbiome's role in critical illness and support exploring microbiota-targeted interventions (e.g., selective probiotics) to improve outcomes.
Keywords: gut microbiome, Dysbiosis, ICU, Enterobacteriaceae, Sepsis, 16S rRNA sequencing
Received: 05 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Wang, Li, Wang, Tian, Zhou, Wang and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huiyu Tian, tianhy1818@sina.com
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