Effects of selective digestive decontamination (SDD) on the gut resistome
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Effects of selective digestive decontamination (SDD) on the gut resistome. / Buelow, Elena; Gonzalez, Teresita Bello; Versluis, Dennis; Oostdijk, Evelien A N; Ogilvie, Lesley A; van Mourik, Maaike S M; Oosterink, Els; van Passel, Mark W J; Smidt, Hauke; D'Andrea, Marco Maria; de Been, Mark; Jones, Brian V; Willems, Rob J L; Bonten, Marc J M; van Schaik, Willem.
In: Journal of Antimicrobial Chemotherapy, Vol. 69, No. 8, 01.08.2014, p. 2215-23.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Effects of selective digestive decontamination (SDD) on the gut resistome
AU - Buelow, Elena
AU - Gonzalez, Teresita Bello
AU - Versluis, Dennis
AU - Oostdijk, Evelien A N
AU - Ogilvie, Lesley A
AU - van Mourik, Maaike S M
AU - Oosterink, Els
AU - van Passel, Mark W J
AU - Smidt, Hauke
AU - D'Andrea, Marco Maria
AU - de Been, Mark
AU - Jones, Brian V
AU - Willems, Rob J L
AU - Bonten, Marc J M
AU - van Schaik, Willem
N1 - © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
PY - 2014/8/1
Y1 - 2014/8/1
N2 - OBJECTIVES: Selective digestive decontamination (SDD) is an infection prevention measure for critically ill patients in intensive care units (ICUs) that aims to eradicate opportunistic pathogens from the oropharynx and intestines, while sparing the anaerobic flora, by the application of non-absorbable antibiotics. Selection for antibiotic-resistant bacteria is still a major concern for SDD. We therefore studied the impact of SDD on the reservoir of antibiotic resistance genes (i.e. the resistome) by culture-independent approaches.METHODS: We evaluated the impact of SDD on the gut microbiota and resistome in a single ICU patient during and after an ICU stay by several metagenomic approaches. We also determined by quantitative PCR the relative abundance of two common aminoglycoside resistance genes in longitudinally collected samples from 12 additional ICU patients who received SDD.RESULTS: The patient microbiota was highly dynamic during the hospital stay. The abundance of antibiotic resistance genes more than doubled during SDD use, mainly due to a 6.7-fold increase in aminoglycoside resistance genes, in particular aph(2″)-Ib and an aadE-like gene. We show that aph(2″)-Ib is harboured by anaerobic gut commensals and is associated with mobile genetic elements. In longitudinal samples of 12 ICU patients, the dynamics of these two genes ranged from a ∼10(4) fold increase to a ∼10(-10) fold decrease in relative abundance during SDD.CONCLUSIONS: ICU hospitalization and the simultaneous application of SDD has large, but highly individualized, effects on the gut resistome of ICU patients. Selection for transferable antibiotic resistance genes in anaerobic commensal bacteria could impact the risk of transfer of antibiotic resistance genes to opportunistic pathogens.
AB - OBJECTIVES: Selective digestive decontamination (SDD) is an infection prevention measure for critically ill patients in intensive care units (ICUs) that aims to eradicate opportunistic pathogens from the oropharynx and intestines, while sparing the anaerobic flora, by the application of non-absorbable antibiotics. Selection for antibiotic-resistant bacteria is still a major concern for SDD. We therefore studied the impact of SDD on the reservoir of antibiotic resistance genes (i.e. the resistome) by culture-independent approaches.METHODS: We evaluated the impact of SDD on the gut microbiota and resistome in a single ICU patient during and after an ICU stay by several metagenomic approaches. We also determined by quantitative PCR the relative abundance of two common aminoglycoside resistance genes in longitudinally collected samples from 12 additional ICU patients who received SDD.RESULTS: The patient microbiota was highly dynamic during the hospital stay. The abundance of antibiotic resistance genes more than doubled during SDD use, mainly due to a 6.7-fold increase in aminoglycoside resistance genes, in particular aph(2″)-Ib and an aadE-like gene. We show that aph(2″)-Ib is harboured by anaerobic gut commensals and is associated with mobile genetic elements. In longitudinal samples of 12 ICU patients, the dynamics of these two genes ranged from a ∼10(4) fold increase to a ∼10(-10) fold decrease in relative abundance during SDD.CONCLUSIONS: ICU hospitalization and the simultaneous application of SDD has large, but highly individualized, effects on the gut resistome of ICU patients. Selection for transferable antibiotic resistance genes in anaerobic commensal bacteria could impact the risk of transfer of antibiotic resistance genes to opportunistic pathogens.
KW - Anti-Bacterial Agents
KW - Bacterial Typing Techniques
KW - Base Sequence
KW - Clostridium
KW - Critical Care
KW - DNA, Bacterial
KW - Decontamination
KW - Drug Resistance, Bacterial
KW - Feces
KW - Humans
KW - Intestines
KW - Male
KW - Microbiota
KW - Molecular Sequence Data
KW - Oropharynx
KW - Phosphotransferases (Alcohol Group Acceptor)
KW - RNA, Ribosomal, 16S
KW - Sequence Analysis, DNA
KW - Symbiosis
KW - Case Reports
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1093/jac/dku092
DO - 10.1093/jac/dku092
M3 - Article
C2 - 24710024
VL - 69
SP - 2215
EP - 2223
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
IS - 8
ER -