Department of Bacteriology, Swedish Institute for Infectious Disease Control, Solna, Sweden.
PLoS One. 2010 Mar 24;5(3):e9836. doi: 10.1371/journal.pone.0009836.
Antibiotic administration is the standard treatment for the bacterium Helicobacter pylori, the main causative agent of peptic ulcer disease and gastric cancer. However, the long-term consequences of this treatment on the human indigenous microbiota are relatively unexplored. Here we studied short- and long-term effects of clarithromycin and metronidazole treatment, a commonly used therapy regimen against H. pylori, on the indigenous microbiota in the throat and in the lower intestine. The bacterial compositions in samples collected over a four-year period were monitored by analyzing the 16S rRNA gene using 454-based pyrosequencing and terminal-restriction fragment length polymorphism (T-RFLP). While the microbial communities of untreated control subjects were relatively stable over time, dramatic shifts were observed one week after antibiotic treatment with reduced bacterial diversity in all treated subjects in both locations. While the microbiota of the different subjects responded uniquely to the antibiotic treatment some general trends could be observed; such as a dramatic decline in Actinobacteria in both throat and feces immediately after treatment. Although the diversity of the microbiota subsequently recovered to resemble the pre treatment states, the microbiota remained perturbed in some cases for up to four years post treatment. In addition, four years after treatment high levels of the macrolide resistance gene erm(B) were found, indicating that antibiotic resistance, once selected for, can persist for longer periods of time than previously recognized. This highlights the importance of a restrictive antibiotic usage in order to prevent subsequent treatment failure and potential spread of antibiotic resistance.
抗生素治疗是幽门螺杆菌（导致消化性溃疡病和胃癌的主要病原体）的标准治疗方法。然而，这种治疗方法对人类本土微生物群的长期影响还相对未知。在这里，我们研究了克拉霉素和甲硝唑治疗（一种常用于治疗幽门螺杆菌的方案）对咽喉和下肠道中本土微生物群的短期和长期影响。通过使用基于 454 的焦磷酸测序和末端限制性片段长度多态性（T-RFLP）分析 16S rRNA 基因，监测了在四年期间收集的样本中的细菌组成。虽然未接受治疗的对照受试者的微生物群落随时间相对稳定，但在抗生素治疗后一周观察到明显的变化，所有治疗受试者在两个部位的细菌多样性均降低。虽然不同受试者的微生物群对抗生素治疗的反应具有独特性，但可以观察到一些一般趋势；例如，治疗后立即在咽喉和粪便中放线菌的数量急剧下降。尽管随后微生物群的多样性恢复到治疗前的状态，但在某些情况下，微生物群仍会受到干扰，最长可达治疗后四年。此外，在治疗四年后发现高水平的大环内酯类抗生素耐药基因 erm(B)，表明抗生素耐药性一旦被选择，其持续时间可能比以前认为的更长。这突出表明需要限制抗生素的使用，以防止随后的治疗失败和潜在的抗生素耐药性传播。
