Gut resistome plasticity in pediatric patients undergoing hematopoietic stem cell transplantation.
Federica D'AmicoMatteo SoveriniDaniele ZamaClarissa ConsolandiMarco SevergniniArcangelo PreteAndrea PessionMonica BaroneSilvia TurroniElena BiagiPatrizia BrigidiRiccardo MasettiSimone RampelliMarco CandelaPublished in: Scientific reports (2019)
The gut microbiome of pediatric patients undergoing allo-hematopoietic stem cell transplantation (HSCT) has recently been considered as a potential reservoir of antimicrobial resistance, with important implications in terms of patient mortality rate. By means of shotgun metagenomics, here we explored the dynamics of the gut resistome - i.e. the pattern of antibiotic resistance genes provided by the gut microbiome - in eight pediatric patients undergoing HSCT, half of whom developed acute Graft-versus-Host Disease (aGvHD). According to our findings, the patients developing aGvHD are characterized by post-HSCT expansion of their gut resistome, involving the acquisition of new resistances, as well as the consolidation of those already present before HSCT. Interestingly, the aGvHD-associated bloom in resistome diversity is not limited to genes coding for resistance to the antibiotics administered along the therapeutic course, but rather involves a broad pattern of different resistance classes, including multidrug resistance, as well as resistance to macrolides, aminoglycosides, tetracyclines and beta-lactams. Our data stress the relevance of mapping the gut resistome in HSCT pediatric patients to define the most appropriate anti-infective treatment post HSCT.
Keyphrases
- patients undergoing
- hematopoietic stem cell
- antimicrobial resistance
- antibiotic resistance genes
- end stage renal disease
- acute myeloid leukemia
- ejection fraction
- high resolution
- wastewater treatment
- newly diagnosed
- peritoneal dialysis
- microbial community
- genome wide
- liver failure
- case report
- climate change
- type diabetes
- deep learning
- cardiovascular disease
- intensive care unit
- coronary artery disease
- patient reported outcomes
- drug induced
- young adults
- artificial intelligence
- heat stress
- childhood cancer
- replacement therapy
- smoking cessation