抗生素使用时长不影响抗生素耐药基因的丰度
创作:aluba 审核:aluba 2021年09月15日
  • 纳入45名使用抗生素进行治疗的患者(23名使用抗生素7天,22名使用抗生素14天)及11名对照;
  • 在第30天,使用抗生素7天的患者与使用抗生素14天的患者的抗生素耐药基因丰度无显著差异;
  • 相比于对照,患者的粪便细菌多样性及聚类无显著差异,但在第14天,患者的粪便菌群物种多样性显著降低;
  • 相比于对照及使用抗生素7天的患者,在治疗期间及治疗后,使用抗生素14天的患者的粪便噬菌体含量显著降低。
主编推荐语
aluba
来自EBioMedicine上发表的一项前瞻性队列研究结果,对45名接受抗生素治疗的患者及11名对照的粪便菌群及耐药组进行分析,发现抗生素使用时长(7天或14天)并未影响抗生素耐药基因的丰度,也不影响肠道菌群的多样性,但可能影响肠道噬菌体的含量。
关键字
延伸阅读本研究的原文信息和链接出处,以及相关解读和评论文章。欢迎读者朋友们推荐!
图片
EBioMedicine [IF:8.143]

Effects of antibiotic duration on the intestinal microbiota and resistome: The PIRATE RESISTANCE project, a cohort study nested within a randomized trial

抗生素使用时长对肠道菌群及耐药组的影响:一项随机试验中的巢式队列研究

10.1016/j.ebiom.2021.103566

2021-09-01, Article

Abstract & Authors:展开

Abstract:收起
BACKGROUND: Shortening antibiotic-treatment durations is a key recommendation of antibiotic-stewardship programmes, yet it is based on weak evidence. We investigated whether halving antibiotic courses would reduce antibiotic-resistance genes (ARG) in the intestinal microbiomes of patients treated for gram-negative bacteraemia.
METHODS: This nested prospective cohort study included adult patients hospitalized at Geneva University Hospitals (Switzerland) participating in the PIRATE randomized trial assessing non-inferiority of shorter antibiotic courses (7 versus 14 days) for gram-negative bacteraemia ('cases') and, simultaneously, hospitalized patients with similar demography and comorbidity yet no antibiotic therapy ('controls'). Stool was collected from case and control patients on days 7, 14, 30 and 90 after antibiotic initiation (day 1) and days 7 and 14 after admission, respectively, and analysed by whole-metagenome shotgun sequencing. The primary outcome was ARG abundance at day 30; secondary outcomes included microbiota-species composition and clustering over time.
FINDINGS: Forty-five patients and 11 controls were included and evaluable; ARG analyses were conducted on the 29 per-protocol patients receiving 7 (±2) days or 14 (±3) days of antibiotic therapy. At day 30, ARGs were not detected at similar abundance in patients receiving 7 and 14 days (median counts/million [mCPM]: 96 versus [vs] 71; p=.38). By day 30, total ARG content between both groups was not significantly different from that of controls at D7 (362 and 370 mCPM vs 314 mCPM, p=.24 and 0.19). There were no significant differences amongst antibiotic-treated patients at any timepoint in bacterial diversity or clustering, but Shannon species diversity was significantly reduced compared to controls through day 14 (median 3.12 and 3.24 in the 7-day and 14-day groups vs 3.61 [controls]; p=.04 and 0.012). Patients treated for 14 days had reduced faecal phage content during and after therapy compared to other patient groups.
INTERPRETATION: Reducing antibiotic durations by half did not result in decreased abundance of ARGs in patients treated for gram-negative bacteraemia, nor did it improve microbiota species diversity.
FUNDING: The study was funded by the University of Geneva's Louis-Jeantet Foundation (grant no. S04_12) and the Swiss National Science Foundation (NRP Smarter Healthcare, grant no. 407,440_167359).

First Authors:
Stefano Leo,Vladimir Lazarevic

Correspondence Authors:
Stefano Leo

All Authors:
Stefano Leo,Vladimir Lazarevic,Elodie von Dach,Laurent Kaiser,Virginie Prendki,Jacques Schrenzel,Benedikt D Huttner,Angela Huttner

评论