**5. Conclusion**

So, are the microbiota-oriented diagnostics and therapy in sepsis a utopia or necessity? In real clinical practice, it is not yet possible to provide real-time monitoring of the microbiome, due to such diagnostics being time-consuming, expensive, complex, and insufficiently studied. Previous works have noted that the gut is a "motor of multiple organ failure and sepsis" [42], and its underestimation earned it a name of "forgotten organ." In the past decades, the number of studies of microbiota in various diseases, including sepsis, has increased drastically and is likely to keep rising. Now it is clear that the "forgotten organ" is a reservoir of pathogens and possibly of genes associated with antibiotic resistance, as well as a marker of disease severity and outcome. Therapy aimed at restoring microbiota equilibrium rather than blindly prescribing broad-spectrum antibiotics may be the best choice. Understanding the metabolic language of microorganisms will serve as a catalyst for the development of new strategies, which will be especially important in the era of antibiotic resistance. New, culturally independent technologies allowing a fast accurate and comprehensive assessment of microbiome will be adapted in the coming years for practical use and wide application. Characterization of changes in ICU patient's microbiome will enable advancement in the development of diagnostic and therapeutic interventions based on changes not only in the microbiota's composition but also in its metabolic profile as well.
