The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
The Microbiology of Multiple Organ Failure: The Proximal Gastrointestinal Tract as an Occult Reservoir of Pathogens
Abstract
The microbiology of infection acquired in the intensive care unit (ICU) was studied prospectively in 205 consecutive patients admitted to a surgical intensive care unit. A multiple organ failure (MOF) score was calculated for each admission. Susceptibility to ICU-acquired infection increased with increasing MOF scores. While Escherichia coli, Bacteroides fragilis, and enterococci were the most common isolates from infections present at the time of ICU admission, Staphylococcus epidermidis, Candida, and Pseudomonas dominated infections occurring in patients with high MOF scores. Mortality correlated highly with infection due to S epidermidis or Candida and only poorly with infection due to Pseudomonas or E coli; significant foci of invasive infection were frequently absent at autopsy. Quantitative cultures of proximal gastrointestinal fluid in 16 of these patients showed Candida, S epidermidis, and Pseudomonas to be the most common isolates, and all but one patient colonized with these organisms had invasive infection with the same organism. The proximal gastrointestinal tract appears to be an important occult reservoir of the predominant pathogens in MOF.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The stomach and proximal small intestine, which are usually sparsely populated, become overgrown by a small number of species, such as E coli, P aeruginosa, and Enterococcus spp.”
From The microbiome and critical illness (2016) · cites this paper as [67]
In the citing paper
“The upper gastrointestinal tract becomes a stagnant reservoir of potential pathogens, the presence of which is predictive of extra-abdominal infections and multiorgan failure.”
From The microbiome and critical illness (2016) · cites this paper as [67]
In the citing paper
“the overgrown microbial reservoir of the stomach and small intestine becomes the primary source community for the mouth and lungs.”
From The microbiome and critical illness (2016) · cites this paper as [67]
Citations
Cites
Baker, S. P., O’Neill, B., Haddon, W. F., & Long, W. B. (1974) · PubMed · Cited by 7,946
APACHE—acute physiology and chronic health evaluation: a physiologically based classification system
Knaus, W. A., Zimmerman, J. E., Wagner, D. P., Draper, E. A., & Lawrence, D. E. (1981) · Critical Care Medicine · doi:10.1097/00003246-198108000-00008 · Cited by 2,190
Cachectin: More Than a Tumor Necrosis Factor
Epstein, F. H., Beutler, B., & Cerami, A. (1987) · New England Journal of Medicine · doi:10.1056/nejm198702123160705 · Cited by 1,423
McCabe, W. R. (1962) · Archives of Internal Medicine · doi:10.1001/archinte.1962.03620240029006 · Cited by 1,378
Fry, D. E. (1980) · Archives of Surgery · doi:10.1001/archsurg.1980.01380020006003 · Cited by 740
Stoutenbeek, C. P., SAENE, H. K. F. V., Miranda, D. R., & Zandstra, D. F. (1984) · Intensive Care Medicine · doi:10.1007/bf00259435 · Cited by 711
Lehmann, V., Freudenberg, M. A., & Galanos, C. (1987) · The Journal of Experimental Medicine · doi:10.1084/jem.165.3.657 · Cited by 547
Multiple Organ Failure in Polytrauma Patients
Faist, E., Baue, A. E., Dittmer, H., & Heberer, G. (1983) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-198309000-00002 · Cited by 494
Multiple, Progressive, or Sequential Systems Failure
Baue, A. E. (1975) · Archives of Surgery · doi:10.1001/archsurg.1975.01360130011001 · Cited by 481
DUMOULIN, G. (1982) · The Lancet · doi:10.1016/s0140-6736(82)90974-6 · Cited by 468
Cited by
Sorted by citations
Items 301–328 of 328
Peri-operative immune-modulation with intravenous immunoglobulins
Dominioni, L. (1998) · European Journal of Anaesthesiology · doi:10.1097/00003643-199811000-00019
Fentanyl-mediated reduction in the bispectral index and 95% spectral edge frequency is age-dependent
Anzawa, N., Hirota, K., Kitayama, M., Kushikata, T., & MATSUKI, A. (2005) · European Journal of Anaesthesiology · doi:10.1017/s0265021503240308
Multiorganic Dysfunction Syndrome in the Elderly Critically Ill Patient
Bonello, M., Ricci, Z., Petras, D., Zamperetti, N., & Ronco, C. (2007) · Springer eBooks · doi:10.1007/978-0-387-72659-5_22
Intravascular Activation of Polymorphonuclear Neutrophils in Critically Ill Anergic Patients
Tellado, J. M., & Christou, N. V. (1993) · Springer eBooks · doi:10.1007/978-3-642-77405-8_24
“The lack of response in the DTH skin test in critically ill patients is a step towards the multiple organ failure syndrome [8].”
BackgroundHajar, N. (1999) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Novel therapeutic approaches for experimental trauma-haemorrhage
Nandra, K. K. (2013)
STUDIES ON 174 CASES OF INTESTINAL OBSTRUCTION WITH REFERENCE TO THE DIAGNOSIS AND APACHE II SCORE
Tanaka, M., Maekawa, T., & Watanabe, Y. (1996) · The journal of the Japanese Practical Surgeon Society · doi:10.3919/ringe1963.57.1566
Scoring Systems for Sepsis and the Multiple Organ Dysfunction Syndrome
Marshall, J. C. (2001) · Elsevier eBooks · doi:10.1016/b978-012655330-7/50068-x
-Allreviews - Selective Decontamination of the Digestive Tract* An Overview
Heyland, D. K., Cook, D. J., Jaeschke, R., Griffith, L. E., Lee, H. N., & Guyatt, G. H. (2017)
Intestinal effects of lung recruitment maneuvers
Claesson, J. (2007) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Management of Multiorgan Failure in Sepsis
Peltan, I. D., & Brown, S. M. (2018) · Springer eBooks · doi:10.1007/978-3-319-73506-1_10
High-Dose Immunoglobulins for Prophylaxis of Severe Sepsis
Dominioni, L., Imperatori, A. S., Gennari, R., & Dionigi, R. (1995) · Springer eBooks · doi:10.1007/978-3-642-79079-9_29
Marino, P. L. (2017) · Elsevier eBooks · doi:10.1016/b978-3-437-23162-9.00003-2
Vincent, J., Bota, D. P., & Ferreira, F. (2003) · Springer eBooks · doi:10.1007/978-88-470-2215-7_35
The Importance of the Gut as a Central Organ in the Pathogenesis of MOF
Fink, M. P. (1993) · Update in intensive care and emergency medicine · doi:10.1007/978-3-642-85011-0_16
Severity of Illness Scoring Systems
Ball, J., Redman, J., & Grounds, R. M. (2002) · Springer eBooks · doi:10.1007/978-3-642-56011-8_81
The Logistic Organ Dysfunction (LOD) System
Gall, J. R. L., Klar, J. M., & Lemeshow, S. A. (1998) · Springer eBooks · doi:10.1007/978-88-470-2271-3_5
Meakins, J. L. (2003) · Springer eBooks · doi:10.1007/978-3-642-55914-3_69
Druml, W. (1991) · Intensivmedizinisches Seminar · doi:10.1007/978-3-7091-9130-9_5
The Microbiome in Critically Ill Patients
Tulli, G., & Zuanetti, G. (2022) · Springer eBooks · doi:10.1007/978-3-031-14612-1_7
Aggressive Enteral Nutrition Reduces Sepsis in the Hypercatabolic Injured Patient
Moore, E. E., & Moore, F. A. (1993) · Springer eBooks · doi:10.1007/978-3-642-77405-8_117
Kryukov, E. V., Ivchenko, E. V., Vb, G., Першко, А. М., Ефимов, И. В., & Sorokin, A. N. (2026) · Bulletin of the Russian Military Medical Academy · doi:10.17816/brmma676910
The Gut-as-Motor of MODS Revisited: Dysbiosis-Driven Multi-Organ Dysfunction in Critical Illness
OYELEKE, S., Adebayo, A. A., Oladokun David, O., & Ikotun, O. (2026) · European Journal of Medical and Health Research · doi:10.59324/ejmhr.2026.4(4).07
Hübner, C. T., Klingebiel, F. K.-L., Kalbas, Y., Ricklin, J., Bästlein, C., Stoeck, C. T., Weisskopf, M., Cinelli, P., Pape, H., & PFEIFER, R. A. (2026) · Injury · doi:10.1016/j.injury.2026.113483
Osterbur, K. (2012) · MOspace Institutional Repository (University of Missouri) · doi:10.32469/10355/15969
Stillings, D. (2001) · PubMed
Metadata
- Authors
- Marshall, J. C.
- Affiliations
- Royal Victoria Hospital (CA)
- Corresponding author
- Marshall, John C.
- Venue
- Archives of Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 1988-03-01
- Volume
- 123
- Issue
- 3
- Pages
- 309
- ISSN
- 0004-0010 (ISSN-L)
- OpenAlex
- W1964088213
- Cited by
- 328
- References
- 36
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 3 · 2012: 6
- FWCI
- 16.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Keywords
- multiple organ failure, intensive care unit-acquired infections, surgical intensive care unit, Escherichia coli, Bacteroides fragilis, Enterococcus, Staphylococcus epidermidis, Candida, Pseudomonas, mortality, intestinal colonization, autopsy findings
- MeSH terms
- Bacteroides fragilis, Candida, Cross Infection, Digestive System, Duodenum, Gastric Juice, Humans, Infections, Intensive Care Units, Middle Aged, Multiple Organ Failure, Prospective Studies, Pseudomonas, Staphylococcus epidermidis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
