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Gut Microbiota Predict Enterococcus Expansion but Not Vancomycin-Resistant Enterococcus Acquisition
mSphere ( IF 4.8 ) Pub Date : 2020-11-18 , DOI: 10.1128/msphere.00537-20
Rishi Chanderraj 1, 2 , Christopher A Brown 2 , Kevin Hinkle 2 , Nicole Falkowski 2 , Piyush Ranjan 2 , Robert P Dickson 2, 3 , Robert J Woods 4, 5
Affiliation  

Vancomycin-resistant Enterococcus (VRE) is a leading cause of hospital-acquired infections and continues to spread despite widespread implementation of pathogen-targeted control guidelines. Commensal gut microbiota provide colonization resistance to VRE, but the role of gut microbiota in VRE acquisition in at-risk patients is unknown. To address this gap in our understanding, we performed a case-control study of gut microbiota in hospitalized patients who did (cases) and did not (controls) acquire VRE. We matched case subjects to control subjects by known risk factors and “time at risk,” defined as the time elapsed between admission until positive VRE screen. We characterized gut bacterial communities using 16S rRNA gene amplicon sequencing of rectal swab specimens. We analyzed 236 samples from 59 matched case-control pairs. At baseline, case and control subjects did not differ in gut microbiota when measured by community diversity (P = 0.33) or composition (P = 0.30). After hospitalization, gut communities of cases and controls differed only in the abundance of the Enterococcus-containing operational taxonomic unit (OTU), with the gut microbiota of case subjects having more of this OTU than time-matched control subjects (P = 0.01). Otherwise, case and control communities after the time at risk did not differ in diversity (P = 0.33) or community structure (P = 0.12). Among patients who became VRE colonized, those having the Blautia-containing OTU on admission had lower Enterococcus relative abundance once colonized (P = 0.004). Our results demonstrate that the 16S profile of the gut microbiome does not predict VRE acquisition in hospitalized patients, likely due to rapid and profound microbiota change. The gut microbiome does not predict VRE acquisition, but it may be associated with Enterococcus expansion, suggesting that these should be considered two distinct processes.

中文翻译:

肠道微生物群预测肠球菌扩增,但不预测耐万古霉素肠球菌的获得

耐万古霉素肠球菌(VRE) 是医院获得性感染的主要原因,尽管广泛实施了针对病原体的控制指南,但仍在继续传播。共生肠道微生物群提供对 VRE 的定植抗性,但肠道微生物群在高危患者 VRE 获得中的作用尚不清楚。为了解决我们理解中的这一差距,我们对曾(病例)和未(对照)获得 VRE 的住院患者进行了肠道微生物群的病例对照研究。我们根据已知的风险因素和“风险时间”(定义为入院到 VRE 筛查阳性之间的时间)将病例受试者与对照受试者进行匹配。我们使用直肠拭子标本的 16S rRNA 基因扩增子测序来表征肠道细菌群落。我们分析了来自 59 个匹配的病例对照对的 236 个样本。在基线时,P = 0.33)或成分(P = 0.30)。住院后,病例和对照组的肠道群落仅在含有肠球菌的操作分类单元(OTU)的丰度上有所不同,病例受试者的肠道微生物群具有比时间匹配的对照组更多的 OTU(P = 0.01)。否则,风险时间后的病例和对照社区在多样性(P = 0.33)或社区结构(P = 0.12)方面没有差异。在 VRE 定植的患者中,入院时含有Blautia OTU 的患者一旦定植,肠球菌相对丰度较低(P= 0.004)。我们的研究结果表明,肠道微生物组的 16S 谱不能预测住院患者的 VRE 获取,这可能是由于微生物群的快速而深刻的变化。肠道微生物组不能预测 VRE 的获得,但它可能与肠球菌的扩增有关,这表明这应该被视为两个不同的过程。
更新日期:2020-11-19
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