Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, Australia
School of Medicine, Sydney Medical School, University of Sydney, Sydney, Australia.
Antimicrob Agents Chemother. 2021 Jan 20;65(2). doi: 10.1128/AAC.01504-20.
Effective antimicrobial stewardship requires a better understanding of the impact of different antibiotics on the gut microflora. Studies with humans are confounded by large interindividual variability and difficulty in identifying control cohorts. However, controlled murine models can provide valuable information. In this study, we examined the impact of a penicillin-like antibiotic (piperacillin-tazobactam [TZP]) or a third-generation cephalosporin (ceftriaxone [CRO]) on the murine gut microbiota by analysis of changes in fecal microbiome composition by 16S rRNA amplicon sequencing and standard microbiology. Resistance to colonization by multidrug-resistant sequence type 131 (ST131) and ST258 was also tested. Changes in microbiome composition and a significant ( < 0.05) decrease in diversity occurred in all treated mice, but dysbiosis was more marked and prolonged after CRO exposure, with a persistent rise in blooms occurred in all antibiotic-treated mice, but for TZP, unlike CRO, these were significant only under direct antibiotic pressure. At the height of dysbiosis after antibiotic termination, the murine gut was highly susceptible to colonization with both multidrug-resistant enterobacterial pathogens. Cohabitation of treated mice with untreated individuals had a notable mitigating effect on dysbiosis of treated guts. The administration of a third-generation cephalosporin caused a more severe imbalance in the murine fecal microflora than that caused by a penicillin/β-lactam inhibitor combination with comparable activity against medically important virulent bacteria. At the height of dysbiosis, both antibiotic treatments equally led to microbial instability associated with loss of resistance to gut colonization by antibiotic-resistant pathogens.
有效的抗菌药物管理需要更好地了解不同抗生素对肠道微生物群的影响。由于个体间的巨大变异性和识别对照队列的困难,人类研究受到了限制。然而,受控的鼠模型可以提供有价值的信息。在这项研究中,我们通过 16S rRNA 扩增子测序和标准微生物学分析粪便微生物组组成的变化,研究了一种类似青霉素的抗生素(哌拉西林-他唑巴坦[TZP])或第三代头孢菌素(头孢曲松[CRO])对鼠肠道微生物群的影响。还测试了对多药耐药性 序列型 131(ST131)和 ST258 的定植抗性。所有接受治疗的小鼠的微生物组组成都发生了变化,且多样性显著(<0.05)下降,但 CRO 暴露后失调更为明显且持续时间更长,持续出现细菌过度生长。所有接受抗生素治疗的小鼠均发生细菌过度生长,但与 CRO 不同,TZP 仅在直接抗生素压力下才具有统计学意义。在抗生素停药后失调达到高峰时,鼠肠道极易被两种多药耐药肠病原体定植。接受治疗的小鼠与未接受治疗的个体共同饲养对治疗后肠道的失调有显著的缓解作用。与具有类似活性的青霉素/β-内酰胺抑制剂组合相比,第三代头孢菌素的使用导致鼠粪便微生物群更严重失衡,对具有医学重要性的毒力细菌。在失调达到高峰时,两种抗生素治疗都同样导致与抗生素耐药病原体定植抗性丧失相关的微生物不稳定。