During the 13th Probiotics, Prebiotics and New Foods Congress, Microbiomepost.com conducted an exclusive interview with Francesco Franceschi from Policlinico Universitario A. Gemelli IRCCS (Roma) in order to discuss how inter-individual differences in gut microbiota composition—often described in terms of enterotypes and broad community shifts—may intersect with immune competence and sepsis risk. 

Franceschi highlights that quantitative and qualitative disruptions of the microbial ecosystem (dysbiosis) can negatively affect immune function, with diet acting as a key modifier: a carbohydrate-heavy, protein-poor pattern may impair antibody-related responses and promote metabolic conditions such as diabetes, which are linked to immune dysfunction and higher infection susceptibility. The interview then focuses on bacterial translocation across a compromised intestinal barrier as a plausible pathway contributing to sepsis. Data from the group’s research indicate that patients with sepsis or septic shock display a distinctly dysbiotic microbiota compared with healthy controls, suggesting that microbial signatures may accompany—or potentially shape—critical illness trajectories. 

Finally, Franceschi reviews preclinical studies investigating probiotic-based strategies (including metabolically relevant bacteria) alongside antibiotics: in animal models, probiotic pre-treatment and continuation during antibiotic therapy have been associated with improved survival compared with antibiotics alone. These findings are encouraging but remain preliminary, underscoring the need for well-designed human trials to assess translatability and clinical impact on sepsis outcomes and mortality.