Fecal Microbial Transplants Reduce Antibiotic-resistant Genes in Patients With Recurrent Clostridium difficile Infection.
Fecal Microbial Transplants Reduce Antibiotic-resistant Genes in Patients With Recurrent Clostridium difficile Infection.
复制标题
粪便微生物移植减少了艰难梭菌感染的患者中抗生素耐药基因。
DOI：
10.1093/cid/ciw185
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发表时间：
2016-06-15
期刊：
影响因子：
--
通讯作者：
Madsen KL
中科院分区：
文献类型：
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作者：
Millan B;Park H;Hotte N;Mathieu O;Burguiere P;Tompkins TA;Kao D;Madsen KL
复发性C.艰难梭菌感染携带大量具有抗生素抗性基因的微生物。粪便微生物移植根除病原体和消除耐药基因，这表明这可能是一个可行的治疗选择，以消除患者的多药耐药细菌。 复发性艰难梭菌感染（RCDI）与反复抗生素治疗和耐药微生物的生长增强有关。这项研究测试了RCDI患者将携带大量耐药微生物的假设，以及粪便微生物群移植（FMT）将减少耐药基因的数量。方法：在一项单中心研究中，RCDI患者（n = 20）通过结肠镜接受来自普通供体的FMT。 在FMT之前和之后从供体（n = 3）和患者收集粪便样品。提取DNA并进行鸟枪宏基因组学。将从人类微生物组计划获得的来自健康队列（n = 87）的结果以及组装的文库与NCBI细菌分类数据库和综合抗生素耐药性数据库进行比对。结果通过含有354个抗生素抗性（ABR）基因的DNA微阵列得到证实。结果：与供者和健康对照组相比，RCDI患者的ABR基因数量和多样性更大。 β-内酰胺，多药外排泵，氟喹诺酮类药物，抗生素灭活ABR基因增加RCDI患者，虽然捐助者主要有四环素耐药。RCDI患者以变形菌为主，大肠埃希菌和克雷伯菌最常见。FMT导致的症状，直接相关的ABR基因的数量和多样性的减少，增加拟杆菌和厚壁菌减少变形菌的决议。FMT后，ABR基因谱在受体中保持长达一年。结论：RCDI患者的耐药微生物数量增加。 FMT在根除病原性耐药微生物和消除ABR基因方面是有效的。
Patients with recurrent C. difficile infection harbor large numbers of microbes with antibiotic resistance genes. Fecal microbial transplantation eradicates pathogenic organisms and eliminates antibiotic-resistance genes suggesting this may be a viable treatment option to eradicate multidrug resistant bacteria from patients. Background. Recurrent Clostridium difficile infection (RCDI) is associated with repeated antibiotic treatment and the enhanced growth of antibiotic-resistant microbes. This study tested the hypothesis that patients with RCDI would harbor large numbers of antibiotic-resistant microbes and that fecal microbiota transplantation (FMT) would reduce the number of antibiotic-resistant genes. Methods. In a single center study, patients with RCDI (n = 20) received FMT from universal donors via colonoscopy. Stool samples were collected from donors (n = 3) and patients prior to and following FMT. DNA was extracted and shotgun metagenomics performed. Results as well as assembled libraries from a healthy cohort (n = 87) obtained from the Human Microbiome Project were aligned against the NCBI bacterial taxonomy database and the Comprehensive Antibiotic Resistance Database. Results were corroborated through a DNA microarray containing 354 antibiotic resistance (ABR) genes. Results. RCDI patients had a greater number and diversity of ABR genes compared with donors and healthy controls. Beta-lactam, multidrug efflux pumps, fluoroquinolone, and antibiotic inactivation ABR genes were increased in RCDI patients, although donors primarily had tetracycline resistance. RCDI patients were dominated by Proteobacteria with Escherichia coli and Klebsiella most prevalent. FMT resulted in a resolution of symptoms that correlated directly with a decreased number and diversity of ABR genes and increased Bacteroidetes and Firmicutes with reduced Proteobacteria. ABR gene profiles were maintained in recipients for up to a year following FMT. Conclusions. RCDI patients have increased numbers of antibiotic-resistant organisms. FMT is effective in the eradication of pathogenic antibiotic-resistant organisms and elimination of ABR genes.
消化道的选择性净化可降低危重患者的死亡率。
影响因子：
15.1
作者：
Schultz, MJ;de Jonge, E;Kesecioglu, J
通讯作者：
Kesecioglu, J