Department of Biology Education, Kyungpook National University, Daegu, Republic of Korea.
Center of Genome Sciences, Rehman Medical Institute Peshawar, Pakistan.
Libyan J Med. 2021 Dec;16(1):1915615. doi: 10.1080/19932820.2021.1915615.
A high prevalence of multidrug-resistant (MDR) pathogens has been reported in adult and pediatric populations of Pakistan. However, data describing the effect of MDR microbes on the gut microbiota is scarce. We designed a cross-sectional pediatric study to investigate the effect of MDR microbes' infection on the gut microbiome and its resistome of children using high-throughput next-generation sequencing (NGS). A cross-sectional study was conducted at a tertiary health care hospital in Peshawar Pakistan, between 5 September 2019 to 15 February 2020. Pediatric patients with acute gastroenteritis (n = 200) were enrolled. All the enrolled pediatric patients underwent initial antimicrobial resistance (AMR) screening using the disk diffusion method. Children with MDR infections were identified and selected for gut microbiome and its resistome profiling using NGS. Out of 200 enrolled pediatric patients, 80 (40%) were found infected with MDR diarrheagenic consisting of 50 (62.5%) infections caused by extended-spectrum beta-lactamase (ESBL) producing while 30 (37.5%) by MDR specie. A total of 63 and 17 antibiotic-resistant genes (ARGs) conferring resistance to 7 and 5 classes of antibiotics were identified in the resistomes of MDR diarrheagenic infected and healthy children, respectively. NGS-based gut microbial profiling of MDR ., ESBL producing infected pediatric patients and healthy controls revealed the predominance of and , respectively. An increased abundance of several pathogenic gram-negative bacteria namely , and was observed in the gut microbiota of children infected with MDR bacterial infections than that of the healthy controls. This work indicates that children with MDR infections have reduced microbial diversity and enriched ARGs than healthy controls. The emergence of MDR bacterial strains and their association with gut dysbiosis needs immediate attention to regulate antibiotics usage in Pakistani children.
在巴基斯坦的成人和儿科人群中，已报告了多种耐药（MDR）病原体的高流行率。然而，描述 MDR 微生物对肠道微生物组影响的数据很少。我们设计了一项横断面儿科研究，使用高通量下一代测序（NGS）来研究 MDR 微生物感染对儿童肠道微生物组及其抗性组的影响。这项横断面研究于 2019 年 9 月 5 日至 2020 年 2 月 15 日在巴基斯坦白沙瓦的一家三级保健医院进行。招募了患有急性胃肠炎的儿科患者（n=200）。所有入组的儿科患者均采用纸片扩散法进行初始抗菌药物耐药（AMR）筛查。确定并选择 MDR 感染的儿童进行肠道微生物组及其抗性组谱分析，使用 NGS。在 200 名入组的儿科患者中，有 80 名（40%）被发现感染了 MDR 腹泻病原体，其中 50 名（62.5%）由产超广谱β-内酰胺酶（ESBL）的病原体引起，30 名（37.5%）由 MDR 病原体引起。在 MDR 腹泻病原体感染和健康儿童的抗性组中，分别鉴定出 63 种和 17 种赋予对 7 种和 5 类抗生素耐药性的抗生素耐药基因（ARGs）。对 MDR 病原体感染的儿科患者和健康对照者的肠道微生物组进行基于 NGS 的分析表明，产 ESBL 的病原体感染的儿科患者和健康对照者中分别以 和 为主。在 MDR 细菌感染的儿童的肠道微生物群中观察到几种致病性革兰氏阴性菌的丰度增加，例如 、 和 。与健康对照组相比，感染 MDR 细菌感染的儿童的肠道微生物多样性减少，且 ARG 丰富。MDR 细菌株的出现及其与肠道菌群失调的关联需要引起立即关注，以规范巴基斯坦儿童的抗生素使用。
