Impact of antimicrobial therapy on the gut microbiome

Abstract

The gut microbiome is now considered an organ unto itself and plays an important role in health maintenance and recovery from critical illness. The commensal organisms responsible for the framework of the gut microbiome are valuable in protection against disease and various physiological tasks. Critical illness and the associated interventions have a detrimental impact on the microbiome. While antimicrobials are one of the fundamental and often life-saving modalities in septic patients, they can also pave the way for subsequent harm because of the resulting damage to the gut microbiome. Contributing to many of the non-specific signs and symptoms of sepsis, the balance between the overuse of antimicrobials and the clinical need in these situations is often difficult to delineate. Given the potency of antimicrobials utilized to treat septic patients, the effects on the gut microbiome are often rapid and long-lasting, in which case full recovery may never be observed. The overgrowth of opportunistic pathogens is of significant concern as they can lead to infections that become increasingly difficult to treat. Continued research to understand the disturbances within the gut microbiome of critically ill patients and their outcomes is essential to help develop future therapies to circumvent damage to, or restore, the microbiome. In this review, we discuss the impact of the antimicrobials often used for the treatment of sepsis on the gut microbiota.

Persistence of wastewater antibiotic resistant bacteria and their genes in human fecal material

“…The importance of these bacterial groups as potential barriers or facilitators for antibiotic-induced bacterial community rearrangements may deserve further investigation. In general, the PCA results ( Figure S1) are in agreement with the literature that suggests that the oral or intravenous antibiotic administration can promote the disturbance of the human gut microbiome (Bhalodi et al, 2019;Francino 2016). The PCA analysis ( Figure S1) suggests that the significant variations observed in Proteobacteria relative abundance (Table S3), might be due to complex fecal bacterial community rearrangements rather than to the increase or decrease of a specific bacterial lineage.…”

Metabolism of Microbiota in Critical Illness (Review and Postulates)

“…new for scientists and physicians, more than 50,000 full-text articles on microbiota, including the results of randomized double-blind trials, are now available online through the PubMed query. The papers not only deal with the microbiota composition in various diseases, but also frequently address the global significance of its metabolic activity, its relation to antimicrobial therapy, complications, and adverse outcomes [68][69][70][71][72][73][74][75][76][77][78][79].…”

Antimicrobial resistance gene prevalence in a population of patients with advanced dementia is related to specific pathobionts

“…Enterobacterales order of Proteobacteria [55][56][57][58][59][60][61]. Of the eleven subjects, all but Subject I were 134 female and all but Subject G were white.…”

“…suggested that levofloxacin has a relatively minor impact on the gut microbiome, primarily 370 reducing levels of Enterobacterales [55][56][57][58][59][60][61], and it may be less-associated with Clostridiodes difficile-associated diarrhea outbreaks than other antimicrobials, including other 372 fluoroquinolones [138]. 373…”

“…We analyzed up to five rectal swabs, taken every 129 three months over the course of a year, from these eleven subjects in the SPREAD cohort [31], 130 using both 16S rRNA and shotgun metagenomics sequencing ( Figure 1A). During their 131 participation in the study, these subjects had received only a single course of levofloxacin (average 132 course of eight days), which has previously been shown to decrease the proportion of the 133Enterobacterales order of Proteobacteria [55][56][57][58][59][60][61]. Of the eleven subjects, all but Subject I were 134 female and all but Subject G were white.…”