PreprintCited by 91Gut microbiota and healthAntibiotic Resistance in BacteriaAntibiotic Use and Resistance

Antibiotics promote intestinal growth of carbapenem-resistant Enterobacteriaceae by enriching nutrients and depleting microbial metabolites

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Yip, Alexander Y. G., King, Olivia G., Omelchenko, Oleksii, Kurkimat, Sanjana, Horrocks, Victoria, Mostyn, Phoebe, Danckert, Nathan, Ghani, Rohma +7 more·2023·Nature Communications

Abstract

The intestine is the primary colonisation site for carbapenem-resistant Enterobacteriaceae (CRE) and serves as a reservoir of CRE that cause invasive infections (e.g. bloodstream infections). Antibiotics disrupt colonisation resistance mediated by the gut microbiota, promoting the expansion of CRE within the intestine. We used ex vivo faecal cultures to measure the impact of antibiotics (that promote CRE intestinal colonisation) on the faecal microbiota from healthy human donors. We demonstrated that antibiotics decreased the abundance of gut commensals (including Bifidobacteriaceae and Bacteroidales ) in human faecal microbiota, resulting in an enrichment of nutrients and a depletion of microbial metabolites. We measured the nutrient utilisation abilities, nutrient preferences, and metabolite inhibition susceptibilities of several carbapenem-resistant Enterobacteriaceae strains, including Escherichia coli , Klebsiella pneumoniae , and Enterobacter hormaechei . Nutrients (which were elevated with antibiotics) acted as carbon and nitrogen sources to support CRE growth, where CRE strains showed an ordered preference for specific nutrients. These nutrients were also increased in faeces from antibiotic-treated mice but decreased following intestinal colonisation with carbapenem-resistant E. coli . Microbial metabolites (which decreased with antibiotics) were inhibitory towards CRE growth in vitro . Carbapenem-resistant E. coli growth was decreased in faecal samples from mice treated with a mixture of inhibitory metabolites compared with PBS-treated mice. These findings demonstrated that killing gut commensals with antibiotics disrupts colonisation resistance by enriching nutrients that support CRE growth and depleting metabolites that inhibit CRE growth. These results support the development of new microbiome therapeutics to prevent CRE intestinal colonisation, which would also prevent the subsequent development of invasive CRE infections.

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  1. [53]Raja Makendran Nandan Raja Rajendran. Enzymatic conversion of RNA from yeast extract to guanosine monophosphate (a flavoring agent). Master’s thesis, Chalmers University of Technology https://odr.chalmers.se/handle/20.500.12380/166692 (2012).

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Authors
Yip, A. Y. G., King, O. G., Omelchenko, O., Kurkimat, S., Horrocks, V., Mostyn, P., Danckert, N., Ghani, R., Satta, G., Jauneikaite, E., Davies, F. J., Clarke, T. B., Mullish, B. H., Marchesi, J. R., & McDonald, J. A. K.
Affiliations
  • Imperial College London (GB)
  • St Mary's Hospital (GB)
  • Imperial College Healthcare NHS Trust (GB)
  • University College London (GB)
  • National Institute for Health and Care Research (GB)
Corresponding author
McDonald, Julie A. K.
Venue
Nature Communications
Publisher
openRxiv
Published
2023-03-25
Volume
14
Issue
1
Pages
5094-5094
ISSN
2041-1723 (ISSN-L)
OpenAlex
W4386070166
Cited by
91
References
82
Citations by year
2026: 24 · 2025: 32 · 2024: 33 · 2023: 2
FWCI
8.11
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Nature Communications (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
Funders
  • Wellcome Trust (107660/Z/15/Z)
  • UK Research and Innovation (MR/X502959/1)
  • National Institute for Health Research Health Protection Research Unit
  • National Institute for Health and Care Research (CL‐2019‐21‐002)
  • University of Warwick
  • Imperial College London
  • Imperial College Healthcare NHS Trust
  • University of Oxford
  • Rosetrees Trust
  • Medical Research Council (MR/W025655/1, 2288243, MR/X502959/1, MR/T005254/1, MR/X020258/1)
  • NIHR Imperial Biomedical Research Centre
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Escherichia coli, broad-spectrum antibiotics, gut microbiota, antibiotic-induced dysbiosis, intestinal colonization, nutrient enrichment, microbial metabolites, inhibitory metabolites, Bifidobacteriaceae, Bacteroidales, gut commensals
MeSH terms
Carbapenem-Resistant Enterobacteriaceae, Nutrients, Animals, Anti-Bacterial Agents, Escherichia coli, Humans, Intestinal Neoplasms, Actinobacteria, Bacteroidetes, Mice

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