Recent medical history has largely viewed our bacterial symbionts as pathogens to be eradicated rather than essential partners in optimal health. However, one of the most exciting scientific advances in recent years has been the realization that commensal microorganisms (our microbiome) play vital roles in our physiology as humans in nutrition, vitamin synthesis, drug metabolism, protection against infection, and recovery from illness. Recent data show loss of “health-promoting” microbes and overgrowth of pathogenic bacteria (dysbiosis) in the Intensive Care Unit (ICU) appears to contribute to nosocomial infections, sepsis, and poor outcomes. Dysbiosis results from many factors, including ubiquitous antibiotic use and altered nutrition delivery in illness. Despite modern antibiotic therapy, infections and mortality from often multi-drug resistant organisms are increasing.

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