Table 3 Proposed research priorities for study of the interaction between the gut microbiome and sepsis

The role of gut microbiome alteration on sepsis predisposition

• Longitudinal microbiome changes in groups at high risk for sepsis

• Microbiome characteristics that indicate high risk for sepsis, including whether these can be used for prediction/diagnosis

• Mechanisms linking increase or decrease of specific taxa to sepsis risk

• How gut microbiome alterations with loss of protective taxa impacts immune dysregulation predisposing to sepsis

• Impact of SCFAs on protection from sepsis

• If altering the gut microbiome can decrease sepsis risk

How the gut microbiome impacts sepsis outcomes

• Correlation of markers of gut microbiome alteration with end-organ dysfunction and mortality

• Whether specific patterns of alteration can predict adverse outcomes in sepsis

• Gut microbiome changes that contribute to dysregulated immune responses of sepsis

• Role of pathobionts and antibiotic resistance genes in antibiotic selection

Whether microbiome-directed therapeutics can impact sepsis outcomes

• Which patients with microbiome alteration may benefit from attempting to restore the gut microbiome to lower risk of sepsis

• Which patients with sepsis may benefit from microbiome-directed therapeutics to improve sepsis outcomes

• The ideal method of gut microbiome therapeutics (i.e., probiotics, FMT)

• The specific dose, timing, and frequency of FMT that may benefit patients in these groups