Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
Antimicrob Resist Infect Control. 2021 Feb 15;10(1):36. doi: 10.1186/s13756-021-00903-0.
According to the Centers for Disease Control's 2015 Hospital Acquired Infection Hospital Prevalence Survey, 1 in 31 hospital patients was infected with at least one nosocomial pathogen while being treated for unrelated issues. Many studies associate antibiotic administration with nosocomial infection occurrence. However, to our knowledge, there is little to no direct evidence of antibiotic administration selecting for nosocomial opportunistic pathogens.
This study aims to confirm gut microbiota shifts in an animal model of antibiotic treatment to determine whether antibiotic use favors pathogenic bacteria.
We utilized next-generation sequencing and in-house metagenomic assembly and taxonomic assignment pipelines on the fecal microbiota of a urinary tract infection mouse model with and without antibiotic treatment.
Antibiotic therapy decreased the number of detectable species of bacteria by at least 20-fold. Furthermore, the gut microbiota of antibiotic treated mice had a significant increase of opportunistic pathogens that have been implicated in nosocomial infections, like Acinetobacter calcoaceticus/baumannii complex, Chlamydia abortus, Bacteroides fragilis, and Bacteroides thetaiotaomicron. Moreover, antibiotic treatment selected for antibiotic resistant gene enriched subpopulations for many of these opportunistic pathogens.
Oral antibiotic therapy may select for common opportunistic pathogens responsible for nosocomial infections. In this study opportunistic pathogens present after antibiotic therapy harbored more antibiotic resistant genes than populations of opportunistic pathogens before treatment. Our results demonstrate the effects of antibiotic therapy on induced dysbiosis and expansion of opportunistic pathogen populations and antibiotic resistant subpopulations of those pathogens. Follow-up studies with larger samples sizes and potentially controlled clinical investigations should be performed to confirm our findings.
根据疾病控制中心 2015 年医院获得性感染医院患病率调查，每 31 名住院患者中就有 1 名患者在接受与其他无关问题的治疗时感染了至少一种医院病原体。许多研究将抗生素给药与医院感染的发生联系起来。然而，据我们所知，几乎没有直接证据表明抗生素给药选择了医院机会性病原体。
本研究旨在确认抗生素治疗动物模型中的肠道微生物群变化，以确定抗生素使用是否有利于病原菌。
我们在尿路感染小鼠模型中使用下一代测序和内部宏基因组组装和分类分配管道，对有和没有抗生素治疗的粪便微生物群进行了研究。
抗生素治疗使可检测细菌物种的数量减少了至少 20 倍。此外，抗生素治疗小鼠的肠道微生物群中机会性病原体的数量显著增加，这些机会性病原体与医院感染有关，如鲍曼不动杆菌/醋酸钙不动杆菌复合体、衣原体流产、脆弱拟杆菌和双歧杆菌。此外，抗生素治疗选择了这些机会性病原体的抗生素耐药基因丰富的亚群。
口服抗生素治疗可能会选择导致医院感染的常见机会性病原体。在这项研究中，抗生素治疗后出现的机会性病原体比治疗前的机会性病原体群体携带更多的抗生素耐药基因。我们的结果表明了抗生素治疗对诱导的菌群失调和机会性病原体种群以及这些病原体的抗生素耐药亚群的扩张的影响。应该进行更大样本量的随访研究和潜在的对照临床研究，以证实我们的发现。
