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The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut

BACKGROUND: Secondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the un...

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Autores principales: Mu, Sucheng, Xiang, Hao, Wang, Yuezhu, Wei, Wei, Long, Xiangyu, Han, Yi, Kuang, Zhongshu, Yang, Yilin, Xu, Feixiang, Xue, Mingming, Dong, Zhimin, Tong, Chaoyang, Zheng, Huajun, Song, Zhenju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944137/
https://www.ncbi.nlm.nih.gov/pubmed/35331299
http://dx.doi.org/10.1186/s13054-022-03943-z
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author Mu, Sucheng
Xiang, Hao
Wang, Yuezhu
Wei, Wei
Long, Xiangyu
Han, Yi
Kuang, Zhongshu
Yang, Yilin
Xu, Feixiang
Xue, Mingming
Dong, Zhimin
Tong, Chaoyang
Zheng, Huajun
Song, Zhenju
author_facet Mu, Sucheng
Xiang, Hao
Wang, Yuezhu
Wei, Wei
Long, Xiangyu
Han, Yi
Kuang, Zhongshu
Yang, Yilin
Xu, Feixiang
Xue, Mingming
Dong, Zhimin
Tong, Chaoyang
Zheng, Huajun
Song, Zhenju
author_sort Mu, Sucheng
collection PubMed
description BACKGROUND: Secondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the underlying mechanism of infection. METHODS: In this prospective, observational case–control study, a total of 34 septic patients, 33 non-septic intensive care unit (ICU) patients and 10 healthy individuals serving as controls were enrolled. Three hundred and twelve fecal samples were collected and subjected to 16S rRNA gene amplicon sequencing. Metagenome sequencing was performed to identify the homology between dominant CRKP or VRE in the intestine and pathogens isolated from secondary infectious sites. C57/BL mice were established as pseudo germ-free animal model by pretreatment with broad-spectrum antibiotics for two weeks. RESULTS: The abundance and diversity of the gut microbiota in septic patients was drastically decreased one week after ICU admission, potentially leading to the enrichment of antibiotic-resistant bacteria, such as CRKP. Furthermore, secondary bloodstream and abdominal infections caused by CRKP or VRE in septic patients occurred after intestinal colonization with the predominant bacterial species. Genomic analysis showed that bacteria isolated from secondary infection had high homology with the corresponding predominant intestinal opportunistic pathogens. In addition, animal model experiments validated the hypothesis that the administration of antibiotics caused the enrichment of CRKP and VRE among the intestinal microbiota, increasing the likelihood of permeation of other tissues and potentially causing subsequent systemic infection in pseudo germ-free mice. CONCLUSION: Our study indicated that the pathogens causing secondary infection in septic patients might originate from the intestinal colonization of pathogens following broad-spectrum antibiotic treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03943-z.
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spelling pubmed-89441372022-03-25 The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut Mu, Sucheng Xiang, Hao Wang, Yuezhu Wei, Wei Long, Xiangyu Han, Yi Kuang, Zhongshu Yang, Yilin Xu, Feixiang Xue, Mingming Dong, Zhimin Tong, Chaoyang Zheng, Huajun Song, Zhenju Crit Care Research BACKGROUND: Secondary nosocomial infections, which are commonly caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus faecium (VRE), often develop in septic patients. This study aimed to identify the origin of secondary systemic pathogens and reveal the underlying mechanism of infection. METHODS: In this prospective, observational case–control study, a total of 34 septic patients, 33 non-septic intensive care unit (ICU) patients and 10 healthy individuals serving as controls were enrolled. Three hundred and twelve fecal samples were collected and subjected to 16S rRNA gene amplicon sequencing. Metagenome sequencing was performed to identify the homology between dominant CRKP or VRE in the intestine and pathogens isolated from secondary infectious sites. C57/BL mice were established as pseudo germ-free animal model by pretreatment with broad-spectrum antibiotics for two weeks. RESULTS: The abundance and diversity of the gut microbiota in septic patients was drastically decreased one week after ICU admission, potentially leading to the enrichment of antibiotic-resistant bacteria, such as CRKP. Furthermore, secondary bloodstream and abdominal infections caused by CRKP or VRE in septic patients occurred after intestinal colonization with the predominant bacterial species. Genomic analysis showed that bacteria isolated from secondary infection had high homology with the corresponding predominant intestinal opportunistic pathogens. In addition, animal model experiments validated the hypothesis that the administration of antibiotics caused the enrichment of CRKP and VRE among the intestinal microbiota, increasing the likelihood of permeation of other tissues and potentially causing subsequent systemic infection in pseudo germ-free mice. CONCLUSION: Our study indicated that the pathogens causing secondary infection in septic patients might originate from the intestinal colonization of pathogens following broad-spectrum antibiotic treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03943-z. BioMed Central 2022-03-24 /pmc/articles/PMC8944137/ /pubmed/35331299 http://dx.doi.org/10.1186/s13054-022-03943-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mu, Sucheng
Xiang, Hao
Wang, Yuezhu
Wei, Wei
Long, Xiangyu
Han, Yi
Kuang, Zhongshu
Yang, Yilin
Xu, Feixiang
Xue, Mingming
Dong, Zhimin
Tong, Chaoyang
Zheng, Huajun
Song, Zhenju
The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title_full The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title_fullStr The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title_full_unstemmed The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title_short The pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
title_sort pathogens of secondary infection in septic patients share a similar genotype to those that predominate in the gut
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944137/
https://www.ncbi.nlm.nih.gov/pubmed/35331299
http://dx.doi.org/10.1186/s13054-022-03943-z
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