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한림대학교

Gut Microbes, 18 Apr 2024, 16 (1) | https://doi.org/10.1080/19490976.2024.2341635 Proton pump inhibitors increase the risk of carbapenem-resistant Enterobacteriaceae colonization by facilitating the transfer of antibiotic resistance genes among bacteria in the gut microbiome

Imchang Lee^a,b, Jae-Won Jo^a,b, Heung-Jeong Woo^c, Ki Tae Suk^d,e, Seung Soon Lee^f, and Bong-Soo Kim^a,b

^aDepartment of Life Science, Multidisciplinary Genome Institute, Hallym University, Chuncheon, Republic of Korea;

^bThe Korean Institute of Nutrition, Hallym University, Chuncheon, Republic of Korea;

^cDivision of Infectious Diseases, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea;

^dDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea;

^eInstitute for Liver and Digestive Diseases, Hallym University, Chuncheon, Republic of Korea;

^fDivision of Infectious Diseases, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea

CONTACT: Seung Soon Lee, Bong-Soo Kim

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) pose a global health threat; however, there is still limited understanding of the risk factors and underlying mechanisms of CRE colonization in the gut microbiome. We conducted a matched case-control study involving 282 intensive care unit patients to analyze influencing covariates on CRE colonization. Subsequently, their effects on the gut microbiome were analyzed in a subset of 98 patients (47 CRE carriers and 51 non-CRE carriers) using whole metagenome sequences. The concomitant use of proton pump inhibitors (PPIs) and antibiotics was a significant risk factor for CRE colonization. The gut microbiome differed according to PPI administration, even within the CRE and non-CRE groups. Moreover, the transfer of mobile genetic elements (MGEs) harboring carbapenem resistance genes (CRGs) between bacteria was higher in the PPI-treated group than in the PPI-not-treated group among CRE carriers. The concomitant use of PPIs and antibiotics significantly alters the gut microbiome and increases the risk of CRE colonization by facilitating the transfer of CRGs among bacteria of the gut microbiome. Based on these findings, improved stewardship of PPIs as well as antibiotics can provide strategies to reduce the risk of CRE colonization, thereby potentially improving patient prognosis.

논문정보

형식Research article
게재일2024년 04월 (BRIC 등록일 2024-04-19)
연구진국내 연구진
분야 생명과학 > 미생물학

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