Evidence map›Paper›PMID 40237647›Full record

Trial reportThe Journal of infectious diseases2025

Gut Colonization With Vancomycin-Resistant Enterococcus Shapes the Gut Microbiome in the Intensive Care Unit.

Heekuk Park, Julian A Abrams, Anne-Catrin Uhlemann, Daniel E Freedberg

Registry-linked trialAbstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03865706 (Prebiotic Inulin to Limit Antimicrobial-Resistant Infections During Critical Illness), which is not on this map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03865706 phase2completednot on this map

Prebiotic Inulin to Limit Antimicrobial-Resistant Infections During Critical Illness: A Phase II Clinical Trial

TypeinterventionalSponsorColumbia UniversityRan2019 to 2024Enrolled94ConditionsAntibiotic Resistant Infection, Nosocomial Infection, Pathogen Transmission, Nutrition DisordersArmsInulin Oral Suspension, Placebo Oral Suspension, Broad-spectrum antibiotics
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Heekuk ParkDivision of Infectious Diseases and Microbiome Core Facility, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.ORCID 0000-0001-5815-9717
Julian A AbramsDigestive and Liver Disease Research Center, Division of Liver and Digestive Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Anne-Catrin UhlemannDivision of Infectious Diseases and Microbiome Core Facility, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.ORCID 0000-0002-9798-4768
Daniel E FreedbergDigestive and Liver Disease Research Center, Division of Liver and Digestive Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.

Funding

The Organoid and Cell Culture CoreP30DK132710 · NIDDK · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Kenneth P. Olive · 2022 to 2026
$7.2M
Micron-scale Spatial Metagenomic Mapping of Microbial Biogeography in the Gastrointestinal TractR01AI132403 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Harris H Wang · 2017 to 2026
$6.0M
The Role of Secondary Bile Acids in Gastro-Esophageal NeoplasiaR01CA272898 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Julian Abrams, Michael Quante · 2022 to 2026
$4.1M
The Role of the Microbiome and Notch Signaling in Esophageal AdenocarcinomaR01CA255298 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ABRAMS, JULIAN · 2021 to 2025
$3.1M
The Oral Microbiome for the Detection of Barretts EsophagusR01CA238433 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ABRAMS, JULIAN · 2019 to 2023
$2.6M
Microbial biomarkers of intestinal MDR colonization after solid organ transplantationR01AI183668 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Tal Korem, Anne-Catrin Uhlemann · 2025 to 2026
$1.7M
Mentoring program in patient-oriented research in microbial genomicsK24AI183182 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Anne-Catrin Uhlemann · 2024 to 2026
$606k
Profiling diarrhea-predominant irritable bowel syndrome (IBS-D) using stool-based RNAsR21AI183029 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WANG, HARRIS H · 2024 to 2025
$446k
Department of Defense PRMPRP 181960NCI NIH HHS R01 CA238433NCI NIH HHS R01 CA255298NCI NIH HHS R01 CA272898NIAID NIH HHS K24 AI183182NIAID NIH HHS R01 AI132403NIAID NIH HHS R01 AI183668NIAID NIH HHS R21 AI183029NIDDK NIH HHS P30 DK132710
6 · The paper itself

Abstract

backgroundGut pathogen colonization with vancomycin-resistant Enterococcus (VRE) is common in the intensive care unit (ICU) and is associated with worse clinical outcomes; however, the timing of VRE colonization and its collateral effects on the gut microbiome are incompletely understood.

methodsMedical ICU patients admitted with sepsis and receiving broad-spectrum antibiotics were sampled via deep rectal swabs at ICU admission and on ICU day 3, 7, 14, and 30. Rectal swabs were cultured for VRE on selective media and analyzed via 16S ribosomal RNA gene sequencing.

resultsNinety patients were sampled (340 longitudinal swabs). VRE positivity rose from 20% at ICU admission to a peak of 33% by ICU day 14 and then modestly declined to 31% by ICU day 30. Paralleling this, alpha diversity fell while Enterococcus relative abundance rose through ICU day 14 with both returning to baseline by ICU day 30. The median relative abundance of Enterococcus was 38% (interquartile range [IQR], 7.4%-75%) for VRE-positive samples compared to 0.01% (IQR, 0%-19%) for VRE-negative samples (rank-sum P < .01); 38 samples had ≥90% Enterococcus and 8 samples were 100% Enterococcus by sequencing. VRE was associated with lower alpha diversity (median Shannon index 1.90 [IQR, 0.89-2.66] if VRE positive versus 2.64 [IQR, 1.58-3.22] if VRE negative; P < .01).

conclusionsVRE gut colonization peaked at ICU day 14 followed by a modest decline and was associated with low alpha diversity. Improved understanding of dynamic changes in the gut microbiome may facilitate successful future ICU interventions. CLINICAL TRIALS REGISTRATION: NCT03865706.

Indexed as

Gastrointestinal MicrobiomeGram-Positive Bacterial InfectionsVancomycin-Resistant EnterococciAgedAnti-Bacterial AgentsFemaleHumansIntensive Care UnitsMaleMiddle AgedRNA, Ribosomal, 16SSepsisAnti-Bacterial AgentsRNA, Ribosomal, 16Scolonization resistanceintensive care unitmicrobiomenosocomial infectionvancomycin-resistant Enterococcus

Identifiers

PMID40237647
PMCPMC12433593

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.