Dhotre SV, Dhotre PS, Mumbre SS, Nagoba BS. Gut barrier dysfunction and multidrug-resistant bacterial translocation in adult critical illness: Mechanistic insights from a systematic review. World J Gastrointest Pathophysiol 2026; 17(2): 122029 [DOI: 10.4291/wjgp.v17.i2.122029]
Corresponding Author of This Article
Basavraj S Nagoba, Assistant Dean, Professor, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. basavraj.nagoba@mimsr.edu.in
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. Jun 22, 2026; 17(2): 122029 Published online Jun 22, 2026. doi: 10.4291/wjgp.v17.i2.122029
Gut barrier dysfunction and multidrug-resistant bacterial translocation in adult critical illness: Mechanistic insights from a systematic review
Shree V Dhotre, Pradnya S Dhotre, Sachin S Mumbre, Basavraj S Nagoba
Shree V Dhotre, Department of Microbiology, Ashwini Rural Medical College, Hospital and Research Centre, Solapur 413006, Maharashtra, India
Pradnya S Dhotre, Department of Biochemistry, Ashwini Rural Medical College, Hospital and Research Centre, Solapur 413001, Maharashtra, India
Sachin S Mumbre, Department of Community Medicine, Ashwini Rural Medical College, Solapur 413006, India
Basavraj S Nagoba, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, Maharashtra, India
Author contributions: Dhotre SV conceptualized and designed the study, developed the study outline, and coordinated manuscript preparation; Dhotre SV, Nagoba BS, Dhotre PS, and Mumbre SS contributed to study design, data interpretation, and critical discussion of the manuscript; Dhotre SV and Nagoba BS performed the literature review, drafted the initial manuscript, and critically revised it for important intellectual content. All authors reviewed and approved the final version of the manuscript.
AI contribution statement: The authors confirm that limited AI-assisted tools, including ChatGPT and Grammarly, were used only for language refinement and grammatical editing during manuscript preparation. No AI tool was used to generate scientific content, interpret results, perform data analysis, design the study, or generate conclusions. No figures or images in the manuscript were AI-generated.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Basavraj S Nagoba, Assistant Dean, Professor, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. basavraj.nagoba@mimsr.edu.in
Received: April 8, 2026 Revised: May 2, 2026 Accepted: June 11, 2026 Published online: June 22, 2026 Processing time: 70 Days and 3.9 Hours
Core Tip
Core Tip: Intestinal colonization with multidrug-resistant organisms often precedes bloodstream infection in critically ill adults. Findings from clinical cohorts, microbiome analyses, and biomarker studies indicate that disruption of epithelial barrier integrity and loss of microbiome-mediated colonization resistance may increase the risk of systemic infection. However, most available evidence is observational and remains susceptible to confounding, particularly from antibiotic exposure, illness severity, and intensive care units-related factors. This PRISMA-compliant systematic review brings together mechanistic and clinical evidence, with careful appraisal of study quality, and identifies gut barrier dysfunction as a plausible - though not definitively causal - contributor to antimicrobial resistance-associated infections, highlighting important directions for future research.
