**6. Methods**

As shown above, the "harmful/beneficial" gut bacteria disbalance is frequently associated with nosocomial pathogens and adverse outcome. The influence of negative factors related to changed internal environment of the macroorganism, and rather aggressive therapy leads to a drastic change in the species diversity of microbiota [40] and, as a consequence, a disturbance of functional activity of microbial community and a development of the maximal disorders that may cause irreversible breakdowns of homeostasis and host body death. A "vicious circle" is created: disturbance of gut microbiome function in critically ill patients leads to overproduction of certain microbial metabolites, which, in turn, have pathological impact on

**1.** Host state: prognosing negative dynamics of homeostasis indices as critical condition progresses and maximally sparing regimens of antimicrobial therapy taking into account the

**2.** Treatment strategies: suppression of overgrowth and targeted correction of bacterial

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

macroorganism's organs and systems (**Figure 4**).

**Figure 4.** Factors affecting the metabolism of microbiota in ICU [41].

important role of microbiome.

metabolism [41].

34 Infectious Process and Sepsis

**5. Conclusion**

Two potential points of effect in sepsis treatment can be identified as:

We used gas chromatography-mass spectrometry (GC-MS) method to quantify metabolites in human serum from septic patients and healthy volunteers. For taxonomic identification of samples, Ion 16S Metagenomics Kits, Ion Reporter metagenomic workflow solution, and Ion Torrent sequencing systems were used. Clinical and laboratory data and APACHE II and SOFA scores in patients were matched. Data were compared by Mann-Whitney U test; p-values less than 0.05 were considered significant.
