TY  - JOUR
A1  - Mücke, Marcus Maximilian
A1  - Rüschenbaum, Sabrina
A1  - Mayer, Amelie
A1  - Mücke, Victoria Therese
A1  - Schwarzkopf, Katharina M.
A1  - Zeuzem, Stefan
A1  - Kehrmann, Jan
A1  - Scholtysik, René
A1  - Lange, Christian
T1  - Stool and sputum microbiome during quinolone prophylaxis of spontaneous bacterial peritonitis: an exploratory study
T2  - Gut pathogens
N2  - Introduction: Quinolone prophylaxis is recommended for patients with advanced cirrhosis at high risk of spontaneous bacterial peritonitis (SBP) or with prior SBP. Yet, the impact of long-term antibiotic prophylaxis on the microbiome of these patients is poorly characterized.
Methods: Patients with liver cirrhosis receiving long-term quinolone prophylaxis to prevent SBP were prospectively included and sputum and stool samples were obtained at baseline, 1, 4 and 12 weeks thereafter. Both bacterial DNA and RNA were assessed with 16S rRNA sequencing. Relative abundance, alpha and beta diversity were calculated and correlated with clinical outcome.
Results:  Overall, 35 stool and 19 sputum samples were obtained from 11 patients. Two patients died (day 9 and 12) all others were followed for 180 days. Reduction of Shannon diversity and bacterial richness was insignificant after initiation of quinolone prophylaxis (p > 0.05). Gut microbiota were significantly different between patients (p < 0.001) but non-significantly altered between the different time points before and after initiation of antibiotic prophylaxis (p > 0.05). A high relative abundance of Enterobacteriaceae > 20% during quinolone prophylaxis was found in three patients. Specific clinical scenarios (development of secondary infections during antibiotic prophylaxis or the detection of multidrug-resistant Enterobacteriaceae) characterized these patients. Sputum microbiota were not significantly altered in individuals during prophylaxis.
Conclusion: The present exploratory study with small sample size showed that inter-individual differences in diversity of gut microbiota were high at baseline, yet quinolone prophylaxis had only a moderate impact. High relative abundances of Enterobacteriaceae during follow-up might indicate failure of or non-adherence to quinolone prophylaxis. However, our results may not be clinically significant given the limitations of the study and therefore future studies are needed to further investigate this phenomenon.
KW  - Quinolones
KW  - Multidrug-resistance
KW  - Infections
KW  - Bacterial abundance
KW  - Enterobacteriaceae
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62815
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-628152
SN  - 1757-4749
N1  - Open Access funding enabled and organized by Projekt DEAL. This study was supported by a research grant from Gilead to MMM as a part of the “Förderprogramm Infektiologie 2017”.
N1  - The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
VL  - 12.2020
IS  - art. 51
SP  - 1
EP  - 10
PB  - BioMed Central
CY  - London
ER  -