Giovanni Gasbarrini

Noncommunicable diseases kill 43 million people worldwide yearly, but one of their key biological drivers, the disruption of the gut microbiome by modifiable environmental factors, is still underappreciated by health stakeholders. The translation of microbiome science into concrete actions, from food safety regulators to public health authorities and policymakers, is urgently needed.

To the Editor, We read with great interest the study by Kitchen and colleagues [1] who showed that exposure to proton pump inhibitors (PPIs) is associated with a distinct microbiological profile in culture-positive spontaneous bacterial peritonitis (SBP). In this study, PPI-exposed patients had a markedly higher prevalence of Gram-positive isolates, particularly Enterococcus spp., Streptococcus spp., and Staphylococcus aureus.