Lab Description
The Duke Anesthesiology Microbiome Profiling Laboratory (Duke AMP Lab), led by Dr. Mara Serbanescu, is a translational research group focused on uncovering how the microbiome influences immune responses and impacts clinical outcomes in perioperative and critically ill patients. We investigate how – in severe stress states such as sepsis, major surgery, and critical illness - microbes residing throughout the body impact immune cells at distal sites and contribute to complications such as organ failure, delirium and cognitive dysfunction, and subsequent infection. Our interdisciplinary approach combines patient biospecimen research with systems biology approaches and model system experiments, leveraging collaborations across microbiology, immunology, anesthesiology and critical care. Our long term goal is to define microbiota-driven mechanisms of inflammation and injury, identify novel biomarkers of disease and disease severity, and identify therapeutic targets that can improve long-term outcomes after critical illness.
How gut health may influence critical illness.
When the community of microbes in the gut (the microbiome) becomes imbalanced, it may weaken the intestinal barrier. This imbalance is thought to allow microbes or their products to “leak” into the body, potentially triggering widespread inflammation and immune problems. These changes can increase vulnerability to serious complications such as infections, sepsis, and brain dysfunction. Our lab investigates these pathways to better understand — and ultimately prevent — poor outcomes in critically ill patients.
Current Active Projects
Unraveling Effects of Gut and Blood Microbial Signatures on Immune Phenotypes and Organ Dysfunction in Sepsis
Funding Source: NIGMS Early-Stage Investigator Maximizing Investigators’ Research Award (1R35GM156920-01)
Major Goals: Explore the role of gut microbial community structure and associated blood microbial signatures of gut origin on immune phenotypes and organ dysfunction in critically ill patients with sepsis.
The Role of Gut Microbial Factors in Delirium in Critically Ill Older Adults
Funding Source: Duke Anesthesiology Dream Innovation Grant
Major Goals: Pilot study to identify potential role of blood and CSF microbiota-mediated metabolites and microbial DNA components in delirium in critically ill older adults.
Role of Nutrition on Gut Microbes and Translocation after Trauma Laparotomy
Funding Source: International Anesthesia Research Society (P10001147)
Major Goals: Investigate effects of targeted nutrition with early parenteral nutrition on the gut microbiome, blood microbial signatures and markers of inflammation in critically ill patients with major abdominal trauma.
Understanding Host-Microbiota Interactions in Critical Illness
Funding Source: Duke Strong Start Physician-Scientist Award
Major Goals: Establish support infrastructure for independent research program focused on host-microbiota interactions in critical illness.
Lab Members
Key Personnel
Collaborators
External Collaborators
In the News
Duke Anesthesiology 2025 DIG Research Project
"The Role of Gut Microbial Factors in Delirium in Critically Ill Older Adults"
October 2025
NIH Grant Awarded to Explore Microbial Influence in Sepsis
The National Institutes of Health’s (NIH) National Institute of General Medical Sciences has awarded Duke Anesthesiology’s Mara Serbanescu, MD, a five-year, $2,018,750 Maximizing Investigators’ Research Award (MIRA) for her project, “Unraveling Effects of Gut and Blood Microbial Signatures on Immune Phenotypes and Organ Dysfunction in Sepsis.”
May 8, 2025
Daily Dose 2023 IARS Mentored Research Award Recipient Interview
Fiber as Foe? Impact of Fiber-Containing Enteral Nutrition on Gut and Oral Microbial Community Dynamics in Critically Ill Trauma Patients: A Pilot-Randomized Trial
May 17, 2024
Dr. Serbanescu Earns a Strong Start Award
Congratulations to Duke Anesthesiology’s Mara Serbanescu, MD, on being among the six Duke University School of Medicine faculty members selected to receive a Physician-Scientist Strong Start Award, designed to support outstanding lab-based clinician-scientists.
January 26, 2024
Dr. Serbanescu Earns Mentored Research Award
The International Anesthesia Research Society has awarded Duke Anesthesiology’s Mara Serbanescu, MD, a two-year $175,000 Mentored Research Award for her project titled, “Role of Nutrition on Gut Microbes and Translocation After Trauma Laparotomy.”
July 19, 2023
Selected Publications
- Serbanescu M, Lee S, Li F, Boppana SH, Elebasy M, White JR, Mintz CD. Effects of Perioperative Exposure on the Microbiome and Outcomes From an Immune Challenge in C57Bl/6 Adult Mice. Anesth Analg. 2025 Mar 10;. doi: 10.1213/ANE.0000000000007467. [Epub ahead of print] PubMed PMID: 40063530; PubMed Central PMCID: PMC12353306.
- Lee S, Wischmeyer PE, Mintz CD, Serbanescu MA. Recent Insights into the Evolving Role of the Gut Microbiome in Critical Care. Crit Care Clin. 2025 Apr;41(2):379-396. doi: 10.1016/j.ccc.2024.11.002. Epub 2024 Dec 3. Review. PubMed PMID: 40021286.
- Serbanescu MA, Wright MC, Arnold J, White JR, Wischmeyer PE. Impact of Fiber-Containing Enteral Nutrition on Microbial Community Dynamics in Critically Ill Trauma Patients: A Pilot-Randomized Trial. Version: v1. [preprint]. 2024 June; [revised 2024 June] doi: doi.org/10.21203/rs.3.rs-4583745/v1.
- Serbanescu MA, Apple CG, Fernandez-Moure JS. Role of Resident Microbial Communities in Biofilm-Related Implant Infections: Recent Insights and Implications. Surg Infect (Larchmt). 2023 Apr;24(3):258-264. doi: 10.1089/sur.2023.009. Review. PubMed PMID: 37010966; PubMed Central PMCID: PMC11074437.
- Serbanescu MA, Da Silva M, Zaky A. Impact of Intensive Care Unit Nutrition on the Microbiome and Patient Outcomes. Anesthesiol Clin. 2023 Mar;41(1):263-281. doi: 10.1016/j.anclin.2022.10.007. Review. PubMed PMID: 36872003; PubMed Central PMCID: PMC10157520.
- Moeller SC, Serbanescu MA, Abernathy JH 3rd, Kostibas MP, Lawton JS, Cha SL. The Epiaortic Ultrasound Diagnosis of Iatrogenic Subadventitial Hematoma. A A Pract. 2020 Nov;14(13):e01333. doi: 10.1213/XAA.0000000000001333. PubMed PMID: 33185407.
- Serbanescu MA, Mathena RP, Xu J, Santiago-Rodriguez T, Hartsell TL, Cano RJ, Mintz CD. General Anesthesia Alters the Diversity and Composition of the Intestinal Microbiota in Mice. Anesth Analg. 2019 Oct;129(4):e126-e129. doi: 10.1213/ANE.0000000000003938. PubMed PMID: 30489316; PubMed Central PMCID: PMC9717490.
- DeMario VM, Sikorski RA, Efron DT, Serbanescu MA, Buchanan RM, Wang EJ, Visagie M, Gehrie EA, Manukyan MC, Noll K, Ken Lee KH, Ness PM, Frank SM. Blood utilization and mortality in victims of gun violence. Transfusion. 2018 Oct;58(10):2326-2334. doi: 10.1111/trf.14925. Epub 2018 Sep 12. PubMed PMID: 30209804.
- Meade CM, Cantos VD, Nasri H, Serbanescu M, Anderson EJ. Epidural Abscess in Lemierre׳s Syndrome. Am J Med Sci. 2017 Sep;354(3):325-326. doi: 10.1016/j.amjms.2016.11.017. Epub 2016 Nov 24. PubMed PMID: 28918841.
- Serbanescu MA, Ramonell KM, Hadley A, Margoles LM, Mittal R, Lyons JD, Liang Z, Coopersmith CM, Ford ML, McConnell KW. Attrition of memory CD8 T cells during sepsis requires LFA-1. J Leukoc Biol. 2016 Nov;100(5):1167-1180. doi: 10.1189/jlb.4A1215-563RR. Epub 2016 Jun 10. PubMed PMID: 27286793; PubMed Central PMCID: PMC5069090.
- Margoles LM, Mittal R, Klingensmith NJ, Lyons JD, Liang Z, Serbanescu MA, Wagener ME, Coopersmith CM, Ford ML. Chronic Alcohol Ingestion Delays T Cell Activation and Effector Function in Sepsis. PLoS One. 2016;11(11):e0165886. doi: 10.1371/journal.pone.0165886. eCollection 2016. PubMed PMID: 27861506; PubMed Central PMCID: PMC5115670.
- Mittal, R, Serbanescu, M, McConnell, K. How Does Critical Illness Alter the Gut? How Does One Manage These Alterations?. In: Evidence-Based Practice of Critical Care Elsevier Health Sciences; 2015 11.