Correlation between gut microbiota structure and nutritional indicators in pediatric sepsis patients in the pediatric intensive care unit

Yang Keke; Liu Xianglei; Yang Linfeng; Zhou Bi; Zhu Feng; Kan Yueyue; Huang Shuiying

doi:10.11986/j.issn.1673-873X.2025.09.13

Abstract：Objective To observe changes in gut microbiota structure in pediatric sepsis patients in the pediatric intensive care unit(PICU)and analyze its association with patients' nutritional indicators,so as to provide a reference for clinical decision-making.Methods A total of 104 pediatric sepsis patients admitted to our hospital from January 2022 to June 2024 were enrolled.All pa-tients underwent gut microbiota profiling and nutritional indicator testing(albumin[ALB]and subcutaneous fat thickness),and the relationships between gut microbiota alterations and nutritional indicators were analyzed.Results Children with malnutrition had lower body mass and longer PICU length of stay than children with normal nutrition,and the differences were statistically significant(P＜0.05);no significant differences were noted in sex distribution,age,height,and other baseline characteristics between the two groups(P＞0.05).At the phylum level,the relative abundances of Firmicutes and Bacteroidetes were significantly lower in mal-nourished children than in well-nourished children(P＜0.05),while Proteobacteria relative abundance was significantly higher in malnourished children(P＜0.05).At the genus level,the relative abundances of Lactobacillus,Alistipes,and Coprococcus were significantly lower in malnourished children than in well-nourished children(P＜0.05),whereas Klebsiella,Esche-richia-Shigella,and Streptococcus were significantly more abundant in malnourished children(P＜0.05).Pearson correla-tion analysis showed that,at the phylum level,the relative abundances of Firmicutes and Bacteroidetes,and at the genus level,the relative abundances of Lactobacillus,Alistipes and Coprococcus were positively correlated with patients' ALB and subcutaneous fat thickness(P＜0.05);conversely,the relative abundance of Proteobacteria at the phylum level and Kleb-siella,Escherichia-Shigella,and Streptococcus at the genus level were negatively correlated with ALB and subcutaneous fat thickness(P＜0.05).Multiple linear regression analysis indicated that the relative abundances of Proteobacteria,Klebsiel-la,and Escherichia-Shigella were factors influencing patients' ALB levels(P＜0.05),and the relative abundances of Alis-tipes and Escherichia-Shigella were factors influencing patients' subcutaneous fat thickness(P＜0.05).Conclusion Gut mi-crobiota structure is disrupted among pediatric patients with sepsis in the PICU,and this disorder is associated with de-creased nutritional indicators(ALB levels)and subcutaneous fat thickness.Clinicians should monitor changes in gut micro-biota structure to prevent malnutrition risk and provide early interventions.