Good microbes, bad genes? The dissemination of antimicrobial resistance in the human microbiome
Open accessAbstract
A global rise in antimicrobial resistance among pathogenic bacteria has proved to be a major public health threat, with the rate of multidrug-resistant bacterial infections increasing over time. The gut microbiome has been studied as a reservoir of antibiotic resistance genes (ARGs) that can be transferred to bacterial pathogens via horizontal gene transfer (HGT) of conjugative plasmids and mobile genetic elements (the gut resistome). Advances in metagenomic sequencing have facilitated the identification of resistome modulators, including live microbial therapeutics such as probiotics and fecal microbiome transplantation that can either expand or reduce the abundances of ARG-carrying bacteria in the gut. While many different gut microbes encode for ARGs, they are not uniformly distributed across, or transmitted by, various members of the microbiome, and not all are of equal clinical relevance. Both experimental and theoretical approaches in microbial ecology have been applied to understand differing frequencies of ARG horizontal transfer between commensal microbes as well as between commensals and pathogens. In this commentary, we assess the evidence for the role of commensal gut microbes in encoding antimicrobial resistance genes, the degree to which they are shared both with other commensals and with pathogens, and the host and environmental factors that can impact resistome dynamics. We further discuss novel sequencing-based approaches for identifying ARGs and predicting future transfer events of clinically relevant ARGs from commensals to pathogens.
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In vivo transfer via conjugation of AR genes from viable probiotic bacteria acting as donors was documented in 1998 and several papers since have confirmed the transferability of AR genes within the gut.
“In vivo transfer via conjugation of AR genes from viable probiotic bacteria acting as donors was documented in 199833 and several papers since have confirmed the transferability of AR genes within the gut for a recent review see.34”
From Emerging issues in probiotic safety: 2023 perspectives (2023) · cites this paper as [34]
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Self-citationInteractions Between Microbial Therapeutics and the Endogenous Microbiome
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Community-promoted antibiotic resistance genes show increased dissemination among pathogensPreprint
Lund, D., Johnning, A., Holmström, M., Varghaei, L., Inda-Díaz, J. S., Bengtsson‐Palme, J., & Kristiansson, E. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.05.12.653433 · Cited by 2 · see citing works
- Authors
- Crits-Christoph, A., Hallowell, H. A., Koutouvalis, K., & Suez, J.
- Affiliations
- Johns Hopkins Bloomberg School of Public Health
- Johns Hopkins University (US)
- Corresponding author
- Suez, Jotham
- Venue
- Gut Microbes
- Publisher
- Informa UK Limited
- Published
- 2022-03-25
- Volume
- 14
- Issue
- 1
- Pages
- 2055944-2055944
- ISSN
- 1949-0976 (ISSN-L)
- 1949-0984
- PMC
- PMC8959533
- OpenAlex
- W4221117022
- Cited by
- 156
- References
- 115
- Citations by year
- 2026: 34 · 2025: 36 · 2024: 45 · 2023: 35 · 2022: 6
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Gut Microbes (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- article
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- antimicrobial resistance genes, gut microbiota, horizontal gene transfer, commensal bacteria, gut resistome, probiotics, conjugative plasmids, mobile genetic elements, multidrug resistance
- MeSH terms
- Gastrointestinal Microbiome, Anti-Bacterial Agents, Bacteria, Genes, Bacterial, Humans, Drug Resistance, Bacterial, Metagenomics, Microbiota
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