The human gut microbiome plays an important role both in health and disease. The use of antibiotics can alter gut microbiota composition, which can cause complications of various kinds. Here we report a whole-genome sequencing metagenomic study of the intestinal microbiota changes caused by Helicobacter pylori eradication therapy. We have found the significant decrease in taxonomic alpha-diversity due to the therapy. The changes observed were more extensive for patients with duodenal ulcer and female ones. We also observed perturbations in intraspecies structures ("strains"), which were significantly higher in group of patients under the therapy than in control group of people without treatment. As well across the patients under the H. pylory eradication therapy we have detected the shifts in the metabolic potentials and resistome. Metabolic pathways associated with the metabolism of carbohydrates and chorismate decreased. Changes in the resistome profile have also been identified: antibiotic resistance genes (ARGs) to macrolides were increased and to tetracyclines -decreased. We also isolated and sequenced Enterococcus faecium strains from two patients. After the therapy this bacterium increased antibiotic resistance in vitro, it had higher ARGs to macrolides and tetracyclines, and this bacterium relative abundance in metagenome was at higher level in comparison with strains before therapy. samples from 40 patients were collected (47.7±13.11 years old, 18 female and 22 male). Before the start of the study, each patient signed an informed consent.
Helicobacter pylori eradication therapy schemeThe eradication therapy was carried out according to the Maastricht scheme (Malfertheiner et al., 2016), which included amoxicillin 1000 mg, clarithromycin 500 mg, bismuth subsalicylate 240 mg, proton pump inhibitor (esomeprazole/pantoprazole) 20 mg. The therapy course lasted for 14 days. Lactulose was used as a prebiotic throughout the therapy course.
Sample preparation and sequencingStool samples were delivered to the laboratory in a frozen state and subsequently were stored at -20°C. Before the DNA extraction procedure, the aggregate state of the samples was evaluated and their weight was determined. The weight of all the samples exceeded 20 grams, which was a sufficient quantity for the extraction of the required amount of DNA. Total DNA extraction was performed as described previously (Tyakht et al., 2013). The whole genome shotgun sequencing on SOLiD 5500W platform in the 50 base pairs in single-end mode was performed according to the manufacturer's recommendations (Life Technologies, Foster City, CA, USA) using the following kits: 5500W Conversion Primers Kit, 5500 W FlowChip V2, 5500 W FlowChip Prep Pack, 5500W Template Amplification Kit v2, 5500 W FWD1 SP Kit, Double, 5500W FWD2 SP Kit, Double, 5500W FWD SR Kit, Double, 5500W FWD Ligase Kit, Double, 5500W Run Cycle Buffer Kit, 5500W FWD Buffer, Double, 5500W Buffer D.
Additional experimental dataThe longitudinal gut metagenomes without intervention were used for the...