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Raymond F, Ouameur AA, Déraspe M, Iqbal N, Gingras H, Dridi B, Leprohon P, Plante PL, Giroux R, Bérubé È, Frenette J, Boudreau DK, Simard JL, Chabot I, Domingo MC, Trottier S, Boissinot M, Huletsky A, Roy PH, Ouellette M, Bergeron MG, Corbeil J. The initial state of the human gut microbiome determines its reshaping by antibiotics. THE ISME JOURNAL 2016; 10:707-20. [PMID: 26359913 PMCID: PMC4817689 DOI: 10.1038/ismej.2015.148] [Citation(s) in RCA: 224] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 02/07/2023]
Abstract
Microbiome studies have demonstrated the high inter-individual diversity of the gut microbiota. However, how the initial composition of the microbiome affects the impact of antibiotics on microbial communities is relatively unexplored. To specifically address this question, we administered a second-generation cephalosporin, cefprozil, to healthy volunteers. Stool samples gathered before antibiotic exposure, at the end of the treatment and 3 months later were analysed using shotgun metagenomic sequencing. On average, 15 billion nucleotides were sequenced for each sample. We show that standard antibiotic treatment can alter the gut microbiome in a specific, reproducible and predictable manner. The most consistent effect of the antibiotic was the increase of Lachnoclostridium bolteae in 16 out of the 18 cefprozil-exposed participants. Strikingly, we identified a subgroup of participants who were enriched in the opportunistic pathogen Enterobacter cloacae after exposure to the antibiotic, an effect linked to lower initial microbiome diversity and to a Bacteroides enterotype. Although the resistance gene content of participants' microbiomes was altered by the antibiotic, the impact of cefprozil remained specific to individual participants. Resistance genes that were not detectable prior to treatment were observed after a 7-day course of antibiotic administration. Specifically, point mutations in beta-lactamase blaCfxA-6 were enriched after antibiotic treatment in several participants. This suggests that monitoring the initial composition of the microbiome before treatment could assist in the prevention of some of the adverse effects associated with antibiotics or other treatments.
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Affiliation(s)
- Frédéric Raymond
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Amin A Ouameur
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Maxime Déraspe
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Naeem Iqbal
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Hélène Gingras
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Bédis Dridi
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Philippe Leprohon
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Pier-Luc Plante
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Richard Giroux
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Ève Bérubé
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Johanne Frenette
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Dominique K Boudreau
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Jean-Luc Simard
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Isabelle Chabot
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Marc-Christian Domingo
- Institut National de Santé Publique du Québec, Laboratoire de Santé Publique du Québec, Montréal, Québec, Canada
| | - Sylvie Trottier
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Maurice Boissinot
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Ann Huletsky
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Paul H Roy
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Marc Ouellette
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Michel G Bergeron
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Jacques Corbeil
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
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Brogden RN, Spencer CM. Cefotaxime. A reappraisal of its antibacterial activity and pharmacokinetic properties, and a review of its therapeutic efficacy when administered twice daily for the treatment of mild to moderate infections. Drugs 1997; 53:483-510. [PMID: 9074846 DOI: 10.2165/00003495-199753030-00009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cefotaxime is well established as an effective and well tolerated antibacterial drug for 3 times daily parenteral treatment of a variety of moderate to severe infections in hospitalised patients. Its frequency of administration has recently been reassessed with a 12-hourly regimen. Comparative studies in hospitalised patients with nosocomial or community-acquired lower respiratory tract infections, demonstrate the similar clinical and bacteriological efficacy of twice daily cefotaxime 1 or 2 g and the same daily dose of ceftriaxone, usually administered once daily. Cefotaxime 2 g twice daily was also similar in efficacy to ceftriaxone 2 g once daily. Retrospective and post-marketing studies also reveal the similar efficacy of cefotaxime administered twice and 3 times daily, and pharmacoeconomic studies suggest that total direct costs of treatment with cefotaxime compared is similar to that with other third generation cephalosporins in currently used dosage regimens. When administered twice daily, cefotaxime is, thus, an effective antibacterial agent for the treatment of hospitalised patients outside the intensive care unit with a variety of mild to moderate non-CNS infections caused by susceptible organisms. When appropriately administered twice daily there is potential to lower the cost of antibacterial treatment without compromising efficacy.
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Affiliation(s)
- R N Brogden
- Adis International Limited, Auckland, New Zealand.
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