Bassis Christine M, Theriot Casey M, Young Vincent B
Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA.
Antimicrob Agents Chemother. 2014 May;58(5):2767-74. doi: 10.1128/AAC.02262-13. Epub 2014 Mar 3.
Antibiotics can play dual roles in Clostridium difficile infection (CDI); antibiotic treatment increases the risk of CDI, and antibiotics are used to treat CDI. The glycylcycline antibiotic tigecycline has broad antimicrobial activity, yet it is rarely associated with the development of CDI, presumably due to its activity against C. difficile. In this study, we investigated how tigecycline treatment affects the structure of the gut microbiota and susceptibility to CDI by treating mice with tigecycline (n = 20) or saline (n = 8) for 10 days. A sequence analysis of the bacterial 16S rRNA gene amplicons was used to monitor changes in the fecal microbiota. A subset of the mice was followed for 5 weeks after the end of treatment. The remaining mice were challenged with C. difficile strain VPI 10463 spores 2 days after the tigecycline treatment ended. Tigecycline treatment resulted in major shifts in the gut microbiota, including large decreases in Bacteroidetes levels and large increases in Proteobacteria levels. Mice with tigecycline-altered microbial communities were susceptible to challenge with C. difficile spores and developed clinical signs of severe CDI. Five weeks after the cessation of tigecycline treatment, the recovery of the bacterial community was incomplete and diversity was lower than in the untreated controls. Antibiotics with intrinsic activity against C. difficile can still alter the microbiota in a way that leads to susceptibility to CDI after discontinuation of the drug. These results indicate that microbiotic dynamics are key in the development of CDI, and a better understanding of these dynamics may lead to better strategies to prevent and treat this disease.
抗生素在艰难梭菌感染(CDI)中可发挥双重作用;抗生素治疗会增加CDI的风险,而抗生素也被用于治疗CDI。甘氨酰环素类抗生素替加环素具有广泛的抗菌活性,但很少与CDI的发生相关,推测这是由于其对艰难梭菌具有活性。在本研究中,我们通过用替加环素(n = 20)或生理盐水(n = 8)处理小鼠10天,来研究替加环素治疗如何影响肠道微生物群的结构以及对CDI的易感性。使用细菌16S rRNA基因扩增子的序列分析来监测粪便微生物群的变化。在治疗结束后,对一部分小鼠进行了5周的跟踪观察。其余小鼠在替加环素治疗结束2天后用艰难梭菌菌株VPI 10463孢子进行攻击。替加环素治疗导致肠道微生物群发生重大变化,包括拟杆菌水平大幅下降和变形菌水平大幅上升。微生物群落因替加环素而改变的小鼠易受艰难梭菌孢子攻击,并出现严重CDI的临床症状。在替加环素治疗停止5周后,细菌群落的恢复不完全,且多样性低于未治疗的对照组。对艰难梭菌具有内在活性的抗生素仍可改变微生物群,导致停药后对CDI易感。这些结果表明,微生物动态变化是CDI发生发展的关键,更好地了解这些动态变化可能会带来更好的预防和治疗该疾病的策略。