Franklin Samantha, Ramont Corina, Batool Maliha, McMahon Stephanie, Sahasrabhojane Pranoti, Blazier John C, Kontoyiannis Dimitrios P, Ni Yang, Galloway-Peña Jessica
Interdisciplinary Graduate Program in Genetics and Genomics, Texas A&M University, College Station, TX 77843, USA.
Department of Statistics, Texas A&M University, College Station, TX 77843, USA.
Antibiotics (Basel). 2025 Jul 30;14(8):770. doi: 10.3390/antibiotics14080770.
Broad-spectrum antibiotics are often used for suspected infections in patients with hematologic malignancies due to the risk of severe infections. Although antibiotic use can lead to antimicrobial resistance and microbiome dysbiosis, the effects of antibiotics on the microbiome and resistome in patients with acute myeloid leukemia (AML) undergoing remission induction chemotherapy (RIC) are not well understood.
Various statistical models were utilized to examine the effects of antibiotic administration on the microbiome and resistome over time, as well as differences in AR-infection (ARI) and colonization (ARC) by important CDC-threats in 119 AML patients.
A greater number of unique antibiotic classes administered correlated with a loss of unique antibiotic resistance genes (ARGs) (R = -0.39, = 0.008). Specifically, although a greater number of oxazolidinone administrations was correlated with a greater loss of diversity (R = -0.58, < 0.001), each additional day of linezolid reduced the risk of ARC by ~30% (HR: 0.663, = 0.047) and decreased the odds of acquiring genes predicted to confer macrolide (HR: 0.50, = 0.026) resistance.
The number of antibiotic administrations and the types of antibiotics used can influence the risk of antibiotic resistance gene (ARG) expansion and ARC events in AML patients undergoing RIC. While certain antibiotics may reduce microbial diversity, they are not always linked to an increase in ARGs or ARC events.
由于存在严重感染风险，广谱抗生素常用于血液系统恶性肿瘤患者的疑似感染。尽管使用抗生素会导致抗菌药物耐药性和微生物群失调，但抗生素对接受缓解诱导化疗（RIC）的急性髓系白血病（AML）患者的微生物群和耐药基因组的影响尚不清楚。
利用各种统计模型来研究抗生素给药随时间对微生物群和耐药基因组的影响，以及119例AML患者中由美国疾病控制与预防中心（CDC）认定的重要威胁引起的抗生素相关感染（ARI）和定植（ARC）的差异。
使用的独特抗生素种类数量越多，与独特抗生素耐药基因（ARG）的丢失相关（R = -0.39，P = 0.008）。具体而言，尽管恶唑烷酮类药物使用次数越多与多样性损失越大相关（R = -0.58，P < 0.001），但利奈唑胺每增加使用一天，ARC风险降低约30%（风险比：0.663，P = 0.047），并降低获得预测赋予大环内酯类耐药性基因的几率（风险比：0.50，P = 0.026）。
抗生素的使用次数和种类会影响接受RIC的AML患者抗生素耐药基因（ARG）扩增和ARC事件的风险。虽然某些抗生素可能会降低微生物多样性，但它们并不总是与ARG或ARC事件增加相关。
