• Denise Battaglini and Antoni Torres.
• Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova.
• Curr Opin Crit Care. 2025 Jan 28.

Purpose Of ReviewThis narrative review discusses the mechanisms connecting gut dysbiosis to adverse clinical outcomes in critically ill patients and explores potential therapeutic strategies.Recent FindingsIn recent years, the study of microbiota in ICUs has gained attention because of its potential effects on patient outcomes. Critically ill patients often face severe conditions, which can compromise their immune systems and lead to opportunistic infections from bacteria typically harmless to healthy individuals. The relationship between aggressive medical treatments and microbiota composition remains unclear. Dysbiosis, characterized by reduced microbial diversity and the loss of beneficial bacteria, can lead to prolonged immunosuppression and increased pathogenic risks, contributing to infections and organ failure. Recent advancements in multiomics technologies have enhanced the understanding of host-microbe interactions and their implications in critical care.SummaryThe microbiota plays an important role in shaping outcomes for critically ill patients. According to evidence, alterations in the gut and lung microbiota are associated with disease severity, mortality, and overall patient recovery. Evolving research opens possibilities for personalized medicine by tailoring treatments based on individual microbiota profiles, though clinical applications are still developing.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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