Gut microbiota may determine severity of life-threatening sepsis infections

Why do some people recover easily from bacterial infections while others rapidly deteriorate into life-threatening sepsis? According to a new study, the answer may lie not only in the invading pathogen itself, but also in the microorganisms already living inside the gut.

Sepsis is a severe condition in which the body's immune system overreacts to infection, causing widespread inflammation and organ damage. In many cases, the excessive immune response itself becomes more dangerous than the bacteria causing the infection.

Recent studies have suggested that gut microbiota play an important role in regulating baseline immune status and may influence susceptibility to infectious diseases. However, the precise microbial factors that determine why some individuals develop severe hyperinflammatory sepsis remained unclear.

A research team led by Dr. Hwi-Won Seo and Dr. Choong-Min Ryu at the Infectious Disease Research Center of the Korea Research Institute of Bioscience and Biotechnology (KRIBB), in collaboration with Prof. Doo-Jin Kim at Chungbuk National University, has now identified a specific gut microbial group that can dramatically worsen sepsis by excessively sensitizing immune cells.

The researchers observed that even genetically identical mice showed strikingly different infection outcomes depending on the composition of their gut microbiota. When exposed to the same amount of pathogenic bacteria, some mice survived with relatively mild symptoms, whereas others rapidly deteriorated and showed significantly lower survival rates due to overwhelming immune activation.

Further analysis revealed that one key factor associated with severe disease was the enrichment of a gut bacterial family known as Muribaculaceae. Among these microbes, a bacterium called Sangeribacter muris KT1-3 was found to produce metabolites that placed immune cells into an excessively hypersensitive state.

As a result, when pathogens invaded the body, the immune system reacted far more aggressively than necessary, leading to uncontrolled inflammation and fatal sepsis.

To confirm that the gut microbiota itself was responsible for these effects, the team also performed fecal microbiota transplantation experiments. When gut microbes associated with severe infection were transferred into otherwise resistant mice, survival rates declined sharply. Conversely, transferring healthier microbial communities improved survival outcomes.

The study further demonstrated that tiny metabolites produced by specific gut microbes can prime immune cells beyond their normal activation threshold. This exaggerated immune sensitivity caused even relatively small external stimuli to trigger explosive inflammatory reactions, ultimately resulting in life-threatening sepsis.

These findings suggest that sepsis severity is determined not only by the virulence of invading pathogens but also by the composition of the gut microbial environment.

The researchers believe the work opens new possibilities for microbiome-based infection management strategies, including predicting susceptibility to severe sepsis and reducing infection risk through modulation of gut microbiota. The approach may also have implications for difficult-to-treat conditions such as infections caused by antibiotic-resistant bacteria.

This study demonstrates that gut microbiota can fundamentally alter the intensity of immune responses and thereby determine infection outcomes. We expect these findings to contribute to the future development of microbiome-based technologies for infection prediction and immune regulation."

Dr. Hwi-Won Seo, study's lead investigator

Korea Research Institute of Bioscience and Biotechnology (KRIBB) is a leading national research institute in South Korea dedicated to cutting-edge research in biotechnology and life sciences. Established in 1985, KRIBB focuses on advancing scientific knowledge in areas such as molecular biology, genomics, bioinformatics, synthetic biology, and aging-related studies. As a government-funded institute, KRIBB plays a pivotal role in driving innovation, supporting national R&D strategies, and collaborating with academic and industrial partners both domestically and internationally.
This research was supported by the Bio and Medical Technology Development Program of the Ministry of Science and ICT and by the Major Research Programs of the Korea Research Institute of Bioscience and Biotechnology (KRIBB).

The study was published on April 30 in Nature Communications (Impact Factor: 15.7), a leading international journal in multidisciplinary science.

The article is titled "A Muribaculaceae-enriched microbiota exacerbates TLR4-dependent Acinetobacter baumannii-induced hyperinflammatory sepsis."

The corresponding authors are Dr. Hwi-Won Seo and Dr. Choong-Min Ryu of KRIBB and Prof. Doo-Jin Kim of Chungbuk National University.