Microbiota Hosts Antibiotics and Bacterial Resistances, Université de Nantes, Nantes, France.
Department of Emergency Medicine, Centre Hospitalier Universitaire de Nantes, Nantes, France.
Nat Microbiol. 2021 Aug;6(8):1043-1054. doi: 10.1038/s41564-021-00920-0. Epub 2021 Jul 5.
Antimicrobial resistance poses a substantial threat to human health. The gut microbiome is considered a reservoir for potential spread of resistance genes from commensals to pathogens, termed the gut resistome. The impact of probiotics, commonly consumed by many in health or in conjunction with the administration of antibiotics, on the gut resistome is elusive. Reanalysis of gut metagenomes from healthy antibiotics-naïve humans supplemented with an 11-probiotic-strain preparation, allowing direct assessment of the gut resistome in situ along the gastrointestinal (GI) tract, demonstrated that probiotics reduce the number of antibiotic resistance genes exclusively in the gut of colonization-permissive individuals. In mice and in a separate cohort of humans, a course of antibiotics resulted in expansion of the lower GI tract resistome, which was mitigated by autologous faecal microbiome transplantation or during spontaneous recovery. In contrast, probiotics further exacerbated resistome expansion in the GI mucosa by supporting the bloom of strains carrying vancomycin resistance genes but not resistance genes encoded by the probiotic strains. Importantly, the aforementioned effects were not reflected in stool samples, highlighting the importance of direct sampling to analyse the effect of probiotics and antibiotics on the gut resistome. Analysing antibiotic resistance gene content in additional published clinical trials with probiotics further highlighted the importance of person-specific metagenomics-based profiling of the gut resistome using direct sampling. Collectively, these findings suggest opposing person-specific and antibiotic-dependent effects of probiotics on the resistome, whose contribution to the spread of antimicrobial resistance genes along the human GI tract merit further studies.
抗微生物药物耐药性对人类健康构成重大威胁。肠道微生物组被认为是从共生菌到病原体的耐药基因潜在传播的储库,称为肠道耐药组。益生菌通常被许多人在健康或与抗生素联合使用时消费,但其对肠道耐药组的影响尚不清楚。对健康、未使用抗生素的人类的肠道宏基因组进行重新分析,这些人补充了一种 11 种益生菌菌株制剂,允许在胃肠道(GI)中直接评估原位肠道耐药组,结果表明益生菌仅在定植允许的个体的肠道中减少抗生素耐药基因的数量。在小鼠和另一组人类中,抗生素疗程导致下胃肠道耐药组的扩张,而通过自体粪便微生物组移植或自发恢复可以减轻这种扩张。相比之下,益生菌通过支持携带万古霉素耐药基因的菌株的繁荣而不是益生菌菌株编码的耐药基因,进一步加剧了 GI 黏膜中的耐药组扩张。重要的是,上述效应并未反映在粪便样本中,这突出了直接采样分析益生菌和抗生素对肠道耐药组的影响的重要性。分析其他发表的益生菌临床试验中的抗生素耐药基因含量,进一步强调了使用直接采样对肠道耐药组进行基于个体的宏基因组学分析的重要性。总的来说,这些发现表明益生菌对耐药组的影响存在个体特异性和抗生素依赖性,其对抗微生物耐药基因在人类胃肠道传播的贡献值得进一步研究。
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