The role of the human gut microbiota in colonization and infection with multidrug-resistant bacteria

Wuethrich, Irene; Pelzer, Benedikt W.; Khodamoradi, Yascha; Vehreschild, Maria J. G. T.

doi:10.1080/19490976.2021.1911279

Cited by 23 publications

(14 citation statements)

References 139 publications

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“…A higher prevalence of Bifidobacterium species in the infant gut is associated with reduced colonization by taxa commonly associated with antimicrobial resistance (AMR) such as Enterobacteriaceae [1,[38][39][40]. By association, we hypothesized that a probiotic supplement containing Bifidobacterium species will reduce the diversity of ARGs detected in the preterm infant gut.…”

Section: Introductionmentioning

confidence: 99%

Capturing the antibiotic resistome of preterm infants reveals new benefits of probiotic supplementation

et al. 2022

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Background Probiotic use in preterm infants can mitigate the impact of antibiotic exposure and reduce rates of certain illnesses; however, the benefit on the gut resistome, the collection of antibiotic resistance genes, requires further investigation. We hypothesized that probiotic supplementation of early preterm infants (born < 32-week gestation) while in hospital reduces the prevalence of antibiotic resistance genes associated with pathogenic bacteria in the gut. We used a targeted capture approach to compare the resistome from stool samples collected at the term corrected age of 40 weeks for two groups of preterm infants (those that routinely received a multi-strain probiotic during hospitalization and those that did not) with samples from full-term infants at 10 days of age to identify if preterm birth or probiotic supplementation impacted the resistome. We also compared the two groups of preterm infants up to 5 months of age to identify persistent antibiotic resistance genes. Results At the term corrected age, or 10 days of age for the full-term infants, we found over 80 antibiotic resistance genes in the preterm infants that did not receive probiotics that were not identified in either the full-term or probiotic-supplemented preterm infants. More genes associated with antibiotic inactivation mechanisms were identified in preterm infants unexposed to probiotics at this collection time-point compared to the other infants. We further linked these genes to mobile genetic elements and Enterobacteriaceae, which were also abundant in their gut microbiomes. Various genes associated with aminoglycoside and beta-lactam resistance, commonly found in pathogenic bacteria, were retained for up to 5 months in the preterm infants that did not receive probiotics. Conclusions This pilot survey of preterm infants shows that probiotics administered after preterm birth during hospitalization reduced the diversity and prevented persistence of antibiotic resistance genes in the gut microbiome. The benefits of probiotic use on the microbiome and the resistome should be further explored in larger groups of infants. Due to its high sensitivity and lower sequencing cost, our targeted capture approach can facilitate these surveys to further address the implications of resistance genes persisting into infancy without the need for large-scale metagenomic sequencing.

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Section: Introductionmentioning

confidence: 99%

Capturing the antibiotic resistome of preterm infants reveals new benefits of probiotic supplementation

et al. 2022

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“…A wide range of host or environment factors, including diet, sleep, and disease, can alter the microbiota diversity and abundancy [ 10 , 11 ]. Of note, the rise of antimicrobial agent-resistant pathogens, combined with reduction of microbiota diversity after antibiotic treatment, has become a significant challenge in the fight against all kinds of invasive infections worldwide [ 14 ]. To prevent the disruption of the microbiota, some microbiota-based treatments, such as fecal microbiota transplantation (FMT) and the administration of probiotics, have been used to “rescue” the disrupted microbiota [ 14 ] ( Figure 1 ).…”

Section: Disruption Of Gut Microbiota After Antibiotic Exposure Results In Recurrent C Difficile Infectionmentioning

confidence: 99%

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

et al. 2021

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Oral vancomycin and metronidazole, though they are the therapeutic choice for Clostridioides difficile infections (CDIs), also markedly disturb microbiota, leading to a prolonged loss of colonization resistance to C. difficile after therapy; as a result, their use is associated with a high treatment failure rate and high recurrent rate. An alternative for CDIs therapy contains the delivery of beneficial (probiotic) microorganisms into the intestinal tract to restore the microbial balance. Recently, mixture regimens containing Lactobacillus species, Saccharomyces boulardii, or Clostridium butyricum have been extensively studied for the prophylaxis of CDIs. Fecal microbiota transplantation (FMT), the transfer of (processed) fecal material from healthy donors to patients for treating CDIs, combined with vancomycin was recommended as the primary therapy for multiple recurrent CDIs (rCDIs). Either probiotics or FMT have been utilized extensively in preventing or treating CDIs, aiming at less disturbance in the microbiota to prevent rCDIs after therapy cessation. Otherwise, many newly developed therapeutic agents have been developed and aim to preserve microbiota during CDI treatment to prevent disease recurrence and might be useful in clinical patients with rCDIs in the future.

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“…We infer that this nonlinear relationship may be due to the "antibiotic resistance" of microbiome, meaning that microbiome may be more sensitive to preliminary antibiotic exposure. 78,79 This hypothesis needs to be elucidated in future studies. The first 6 months after birth are crucial for the development of a healthy microbiome.…”

Section: Discussionmentioning

confidence: 99%

Association of infant antibiotic exposure and risk of childhood asthma: A meta-analysis

Zhang

Wang

et al. 2021

World Allergy Organization Journal

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Background: Infant antibiotic exposure may be associated with childhood asthma development.Objective: To examine and detail this association considering potential confounders.Study design: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for publications from January 2011 to March 2021. Eligible studies were independently reviewed to extract data and assess quality. Random effect model was used to pool odds ratio (OR) and corresponding 95% confidence intervals (CIs).Results: A total of 52 studies were included. The association of infant antibiotic exposure and childhood asthma was statistically significant for overall analysis (OR, 1.37; 95% CI, 1.29-1.45) and for studies that addressed reverse causation (RC) and confounding by indication (CbI) (1.19; 95% CI, 1.11-1.28). Significance remained after stratification by adjustment for maternal antibiotic exposure, medical consultation, sex, smoke exposure, parental allergy, birth weight, and delivery mode. In detailed analyses, macrolides (OR, 1.56; 95% CI, 1.31-1.86), antibiotic course5 (OR, 1.79; 95% CI, 1.36-2.36), exposure within 1 week of birth (OR, 1.82; 95% CI, 1.34-2.47), asthma developed among 1-3 years (OR, 1.84; 95% CI, 1.63-2.08), short time lag between exposure and asthma onset (OR, 2.05; 95% CI, 1.91-2.20), persistent asthma (OR, 2.61; 95% CI, 1.49-4.59), and atopic asthma (OR, 2.14; 95% CI, 1.58-2.90) showed higher pooled estimates. Conclusion:Infant antibiotic exposure is associated with increased risk of childhood asthma considering confounding, and the association varied with different settings of exposure and outcomes. This highlights the need for prevention of asthma after early antibiotic exposure. Heterogeneity among studies called for caution when interpretation.

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The role of the human gut microbiota in colonization and infection with multidrug-resistant bacteria

Cited by 23 publications

References 139 publications

Capturing the antibiotic resistome of preterm infants reveals new benefits of probiotic supplementation

Capturing the antibiotic resistome of preterm infants reveals new benefits of probiotic supplementation

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

Association of infant antibiotic exposure and risk of childhood asthma: A meta-analysis

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