Microbiome and trauma

The microbiome, inclusive of the body’s microbiota and their genes and gene products (metabolites), is beginning to be recognized as playing a major role in human health and disease. The microbiome has a major influence on host immune development and function and can be an unappreciated reservoir for potential pathogens. Traumatic injury and critical illness significantly and rapidly alter the microbiome both compositionally and functionally. These perturbations to the microbiome can place patients at increased risk for infectious and inflammatory complications. Furthermore, trauma care consisting of surgical interventions, antibiotic exposure, blood transfusions, and the use of artificial nutrition can further disturb the microbiome and shift its composition, membership, and function to a pathobiome consisting of highly virulent and resistant heath care-associated organisms, their genes, and their toxins. Exciting work is emerging to demonstrate that a more complete understanding of the role of the microbiome on the course and outcome of traumatic injury may inform novel approaches to preserve its health-promoting activity while containing its untoward effect on the immune and inflammatory system.