Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>

ABSTRACT Infection with carbapenem-resistant Enterobacteriaceae (CRE) has become an important challenge in health care settings and a growing concern worldwide. Since infection is preceded by colonization, an understanding of the latter may reduce CRE infections. We aimed to characterize the gut mic...

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Autores principales:	Hila Korach-Rechtman, Maysaa Hreish, Carmit Fried, Shiran Gerassy-Vainberg, Zaher S. Azzam, Yechezkel Kashi, Gidon Berger
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2020
Materias:	carbapenem-resistant Enterobacteriaceae CRE microbiome intestinal dysbiosis antibiotic resistance Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/c98c43228e514623946fa8371fc3a7ec
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spelling	oai:doaj.org-article:c98c43228e514623946fa8371fc3a7ec2021-11-15T15:29:16ZIntestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>10.1128/mSphere.00173-202379-5042https://doaj.org/article/c98c43228e514623946fa8371fc3a7ec2020-04-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00173-20https://doaj.org/toc/2379-5042ABSTRACT Infection with carbapenem-resistant Enterobacteriaceae (CRE) has become an important challenge in health care settings and a growing concern worldwide. Since infection is preceded by colonization, an understanding of the latter may reduce CRE infections. We aimed to characterize the gut microbiota in CRE carriers, assuming that microbiota alterations precede CRE colonization. We evaluated the gut microbiota using 16S rRNA gene sequencing extracted of fecal samples collected from hospitalized CRE carriers and two control groups, hospitalized noncarriers and healthy adults. The microbiota diversity and composition in CRE-colonized patients differed from those of the control group participants. These CRE carriers displayed lower phylogenetic diversity and dysbiotic microbiota, enriched with members of the family Enterobacteriaceae. Concurrent with the enrichment in Enterobacteriaceae, a depletion of anaerobic commensals was observed. Additionally, changes in several predicted metabolic pathways were observed for the CRE carriers. Concomitantly, we found higher prevalence of bacteremia in the CRE carriers. Several clinical factors that might induce changes in the microbiota were examined and found to be insignificant between the groups. The compositional and functional changes in the microbiota of CRE-colonized patients are associated with increased risk for systemic infection. Our study results provide justification for attempts to restore the dysbiotic microbiota with probiotics or fecal transplantation. IMPORTANCE The gut microbiota plays important roles in the host’s normal function and health, including protection against colonization by pathogenic bacteria. Alterations in the gut microbial profile can potentially serve as an early diagnostic tool, as well as a therapeutic strategy against colonization by and carriage of harmful bacteria, including antibiotic-resistant pathogens. Here, we show that the microbiota of hospitalized patients demonstrated specific taxa which differed between carriers of carbapenem-resistant Enterobacteriaceae (CRE) and noncarriers. The difference in the microbiota also dictates alterations in microbiome-specific metabolic capabilities, in association with increased prevalence of systemic infection. Reintroducing specific strains and/or correction of dysbiosis with probiotics or fecal transplantation may potentially lead to colonization by bacterial taxa responsible for protection against or depletion of antibiotic-resistant pathogens.Hila Korach-RechtmanMaysaa HreishCarmit FriedShiran Gerassy-VainbergZaher S. AzzamYechezkel KashiGidon BergerAmerican Society for Microbiologyarticlecarbapenem-resistant EnterobacteriaceaeCREmicrobiomeintestinal dysbiosisantibiotic resistanceMicrobiologyQR1-502ENmSphere, Vol 5, Iss 2 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	carbapenem-resistant Enterobacteriaceae CRE microbiome intestinal dysbiosis antibiotic resistance Microbiology QR1-502
spellingShingle	carbapenem-resistant Enterobacteriaceae CRE microbiome intestinal dysbiosis antibiotic resistance Microbiology QR1-502 Hila Korach-Rechtman Maysaa Hreish Carmit Fried Shiran Gerassy-Vainberg Zaher S. Azzam Yechezkel Kashi Gidon Berger Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
description	ABSTRACT Infection with carbapenem-resistant Enterobacteriaceae (CRE) has become an important challenge in health care settings and a growing concern worldwide. Since infection is preceded by colonization, an understanding of the latter may reduce CRE infections. We aimed to characterize the gut microbiota in CRE carriers, assuming that microbiota alterations precede CRE colonization. We evaluated the gut microbiota using 16S rRNA gene sequencing extracted of fecal samples collected from hospitalized CRE carriers and two control groups, hospitalized noncarriers and healthy adults. The microbiota diversity and composition in CRE-colonized patients differed from those of the control group participants. These CRE carriers displayed lower phylogenetic diversity and dysbiotic microbiota, enriched with members of the family Enterobacteriaceae. Concurrent with the enrichment in Enterobacteriaceae, a depletion of anaerobic commensals was observed. Additionally, changes in several predicted metabolic pathways were observed for the CRE carriers. Concomitantly, we found higher prevalence of bacteremia in the CRE carriers. Several clinical factors that might induce changes in the microbiota were examined and found to be insignificant between the groups. The compositional and functional changes in the microbiota of CRE-colonized patients are associated with increased risk for systemic infection. Our study results provide justification for attempts to restore the dysbiotic microbiota with probiotics or fecal transplantation. IMPORTANCE The gut microbiota plays important roles in the host’s normal function and health, including protection against colonization by pathogenic bacteria. Alterations in the gut microbial profile can potentially serve as an early diagnostic tool, as well as a therapeutic strategy against colonization by and carriage of harmful bacteria, including antibiotic-resistant pathogens. Here, we show that the microbiota of hospitalized patients demonstrated specific taxa which differed between carriers of carbapenem-resistant Enterobacteriaceae (CRE) and noncarriers. The difference in the microbiota also dictates alterations in microbiome-specific metabolic capabilities, in association with increased prevalence of systemic infection. Reintroducing specific strains and/or correction of dysbiosis with probiotics or fecal transplantation may potentially lead to colonization by bacterial taxa responsible for protection against or depletion of antibiotic-resistant pathogens.
format	article
author	Hila Korach-Rechtman Maysaa Hreish Carmit Fried Shiran Gerassy-Vainberg Zaher S. Azzam Yechezkel Kashi Gidon Berger
author_facet	Hila Korach-Rechtman Maysaa Hreish Carmit Fried Shiran Gerassy-Vainberg Zaher S. Azzam Yechezkel Kashi Gidon Berger
author_sort	Hila Korach-Rechtman
title	Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
title_short	Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
title_full	Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
title_fullStr	Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
title_full_unstemmed	Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>
title_sort	intestinal dysbiosis in carriers of carbapenem-resistant <italic toggle="yes">enterobacteriaceae</italic>
publisher	American Society for Microbiology
publishDate	2020
url	https://doaj.org/article/c98c43228e514623946fa8371fc3a7ec
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Intestinal Dysbiosis in Carriers of Carbapenem-Resistant <italic toggle="yes">Enterobacteriaceae</italic>

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