The role of bacterial translocation in sepsis: a new target for therapy

Abstract

Sepsis is a leading cause of death in critically ill patients, primarily due to multiple organ failures. It is associated with a systemic inflammatory response that plays a role in the pathogenesis of the disease. Intestinal barrier dysfunction and bacterial translocation (BT) play pivotal roles in the pathogenesis of sepsis and associated organ failure. In this review, we describe recent advances in understanding the mechanisms by which the gut microbiome and BT contribute to the pathogenesis of sepsis. We also discuss several potential treatment modalities that target the microbiome as therapeutic tools for patients with sepsis.

Keywords: bacterial translocation; dysbiosis; gut microbiome; sepsis.

Figure 1.

(a) Variables associated with the development of sepsis. Bacterial factors, including bacteria and host factors, include age, ethnicity, the immune system, diet, background diseases, and medications. Each factor represents a potential target for therapeutic interventions. The roles of dysbiosis and BT in the pathogenesis of sepsis are highlighted. (b) A schematic presentation of several potential therapeutic measures for sepsis, focusing on gut dysbiosis. A shift between a normal/healthy/low sepsis risk microbiome and an altered microbiome and a sepsis microbiome or that the altered microbiome (‘dysbiosis’) increases the risk of sepsis.