同时暴露于抗生素和模拟胃肠液的孢子的存活及形态变化:对抗生素管理的启示

Survival and Morphological Changes of Spores Co-Exposed to Antibiotics and Simulated Gastrointestinal Fluids: Implications for Antibiotic Stewardship.

作者信息

Yang Yi-Meng, Zhang Meng-Yue, Wu Ying-Ying, Zhang Lu, Zhang Yi-Xuan

机构信息

School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, China.

Hangzhou Grand Biologic Pharmaceutical Inc., Hangzhou 310030, China.

出版信息

Microorganisms. 2025 Jun 10;13(6):1347. doi: 10.3390/microorganisms13061347.

Abstract

Probiotics are often advised to be taken separately from antibiotics due to their sensitivity to antibiotic activity and gastrointestinal (GI) stress. However, spores, as next-generation probiotics, may withstand concurrent use with antibiotics due to their unique structural adaptations. This study systematically evaluated the survival rates and morphological changes of spores exposed to 10 clinically relevant antibiotics in simulated gastric/intestinal fluids, exploring their feasibility for co-administration with antibiotics. Survival rates of spores were tested against 10 antibiotics across four classes (β-lactams, macrolides, aminoglycosides, and tetracyclines) in simulated GI fluids. Time-kill curves analyzed spore survival over 0-4 h, while scanning electron microscopy (SEM) observed spore wall integrity and morphological changes under different conditions. The spore survival rates remained >89% in intestinal fluid and >60% in gastric fluid across all antibiotics. SEM revealed gastric acid and proteolysis increased spore wall fragmentation, reducing resistance, whereas the intestinal environment preserved spore integrity. This study was the first to demonstrate that spores can survive simultaneous exposure to antibiotics in the gastrointestinal tract, challenging traditional probiotic usage guidelines. The findings support their co-administration with antibiotics to simplify dosing regimens and improve medication adherence. Such an approach advances antimicrobial stewardship by optimizing therapeutic strategies for antibiotic-probiotic combinations.

摘要

由于益生菌对抗生素活性和胃肠道应激敏感,通常建议将其与抗生素分开服用。然而,作为下一代益生菌的芽孢,由于其独特的结构适应性,可能能够耐受与抗生素同时使用。本研究系统评估了在模拟胃液/肠液中暴露于10种临床相关抗生素的芽孢的存活率和形态变化,探讨了它们与抗生素联合使用的可行性。在模拟胃肠道液体中,针对四类(β-内酰胺类、大环内酯类、氨基糖苷类和四环素类)的10种抗生素测试了芽孢的存活率。时间杀灭曲线分析了0-4小时内芽孢的存活情况,而扫描电子显微镜(SEM)观察了不同条件下芽孢壁的完整性和形态变化。在所有抗生素作用下,芽孢在肠液中的存活率均保持>89%,在胃液中的存活率>60%。扫描电子显微镜显示胃酸和蛋白水解作用增加了芽孢壁的破碎,降低了抗性,而肠道环境保持了芽孢的完整性。本研究首次证明芽孢能够在胃肠道中同时暴露于抗生素的情况下存活,这对传统的益生菌使用指南提出了挑战。这些发现支持将它们与抗生素联合使用,以简化给药方案并提高用药依从性。这种方法通过优化抗生素-益生菌组合的治疗策略推进了抗菌管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca45/12196182/2a94adab2040/microorganisms-13-01347-g001.jpg

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