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A Clinical Study Provides the First Direct Evidence That Interindividual Variations in Fecal ß-Lactamase Activity Affect the Gut Mycobiota Dynamics in Response to ß-Lactam Antibiotics.
Delavy, Margot; Burdet, Charles; Sertour, Natacha; Devente, Savannah; Docquier, Jean-Denis; Grall, Nathalie; Volant, Stevenn; Ghozlane, Amine; Duval, Xavier; Mentré, France; d'Enfert, Christophe; Bougnoux, Marie-Elisabeth.
Afiliación
  • Delavy M; Institut Pasteurgrid.428999.7, Université Paris Cité, INRAE USC2019, Unité Biologie et Pathogénicité Fongiques, Paris, France.
  • Burdet C; Université Paris Cité, IAME, INSERM, Paris, France.
  • Sertour N; AP-HP, Département d'Epidémiologie, Biostatistique et Recherche Clinique, Hôpital Bichat, Paris, France.
  • Devente S; Institut Pasteurgrid.428999.7, Université Paris Cité, INRAE USC2019, Unité Biologie et Pathogénicité Fongiques, Paris, France.
  • Docquier JD; Università di Siena, Dipartimento di Biotecnologie Mediche, Siena, Italy.
  • Grall N; Università di Siena, Dipartimento di Biotecnologie Mediche, Siena, Italy.
  • Volant S; Université Paris Cité, IAME, INSERM, Paris, France.
  • Ghozlane A; Institut Pasteurgrid.428999.7, Université Paris Cité, Bioinformatics and Biostatistics Hub, Paris, France.
  • Duval X; Institut Pasteurgrid.428999.7, Université Paris Cité, Bioinformatics and Biostatistics Hub, Paris, France.
  • Mentré F; Université Paris Cité, IAME, INSERM, Paris, France.
  • d'Enfert C; Clinical investigation center, INSERM 1425, IAME, Hôpital Bichat, Assistance Publique des Hôpitaux de Paris (APHP), Université Paris Cité, Paris, France.
  • Bougnoux ME; Université Paris Cité, IAME, INSERM, Paris, France.
mBio ; 13(6): e0288022, 2022 12 20.
Article en En | MEDLINE | ID: mdl-36448778
Antibiotics disturb the intestinal bacterial microbiota, leading to gut dysbiosis and an increased risk for the overgrowth of opportunistic pathogens. It is not fully understood to what extent antibiotics affect the fungal fraction of the intestinal microbiota, the mycobiota. There is no report of the direct role of antibiotics in the overgrowth in healthy humans of the opportunistic pathogenic yeast Candida albicans. Here, we have explored the gut mycobiota of 22 healthy subjects before, during, and up to 6 months after a 3-day regimen of third-generation cephalosporins (3GCs). Using ITS1-targeted metagenomics, we highlighted the strong intra- and interindividual diversity of the healthy gut mycobiota. With a specific quantitative approach, we showed that C. albicans prevalence was much higher than previously reported, with all subjects but one being carriers of C. albicans, although with highly variable burdens. 3GCs significantly altered the mycobiota composition and the fungal load was increased both at short and long term. Both C. albicans relative and absolute abundances were increased but 3GCs did not reduce intersubject variability. Variations in C. albicans burden in response to 3GC treatment could be partly explained by changes in the levels of endogenous fecal ß-lactamase activity, with subjects characterized by a high increase of ß-lactamase activity displaying a lower increase of C. albicans levels. A same antibiotic treatment might thus affect differentially the gut mycobiota and C. albicans carriage, depending on the treated subject, suggesting a need to adjust the current risk factors for C. albicans overgrowth after a ß-lactam treatment. IMPORTANCE Fungal infections are redoubtable healthcare-associated complications in immunocompromised patients. Particularly, the commensal intestinal yeast Candida albicans causes invasive infections in intensive care patients and is, therefore, associated with high mortality. These infections are preceded by an intestinal expansion of C. albicans before its translocation into the bloodstream. Antibiotics are a well-known risk factor for C. albicans overgrowth but the impact of antibiotic-induced dysbiosis on the human gut mycobiota-the fungal microbiota-and the understanding of the mechanisms involved in C. albicans overgrowth in humans are very limited. Our study shows that antibiotics increase the fungal proportion in the gut and disturb the fungal composition, especially C. albicans, in a subject-dependent manner. Indeed, variations across subjects in C. albicans burden in response to ß-lactam treatment could be partly explained by changes in the levels of endogenous fecal ß-lactamase activity. This highlighted a potential new key factor for C. albicans overgrowth. Thus, the significance of our research is in providing a better understanding of the factors behind C. albicans intestinal overgrowth, which might lead to new means to prevent life-threatening secondary infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Candida albicans / Disbiosis Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: MBio Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Candida albicans / Disbiosis Tipo de estudio: Risk_factors_studies Límite: Humans Idioma: En Revista: MBio Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos