BIOME cohort: Multi‐system microbiome dynamics and clinical outcomes in massive burn injury patients

Massive burn injuries (MBIs) are associated with high mortality and disability rates, primarily due to microbial-driven sepsis from extensive skin barrier loss and subsequent scar formation. This makes MBI a compelling model for studying multi-system microbial dysbiosis following skin barrier destruction. We launched the Burn & Trauma Injury Organisms and Microbiome Ecology (BIOME) project, planning to enroll at least 150 MBI patients from 50 hospitals across 28 provinces, autonomous regions, and municipalities in China. The cohort includes skin swabs, intestinal and oral samples, and longitudinal clinical data collected from within 72 h post-injury through 1 year of follow-up. This multicenter, prospective, longitudinal cohort will establish a comprehensive clinical microbiota resource for patients with MBI. By integrating multi-system microbiome profiling with clinical outcomes, the BIOME project aims to elucidate the translational role of microbiota reconstruction as a potential target for diagnosis, prognosis, and therapeutic intervention in severe burn care.