Nat Commun: A new perspective on antibiotic resistance research! For the first time, scientists have discovered that drug-resistant bacteria may be able to transfer from the intestines to the lungs, increasing the risk of fatal infections!

Bacteria have the potential to move between different parts of the human body, but researchers still know little
about the dynamics of bacterial migration within the host organism and the consequences thereof 。 Recently, a study entitled "Gut to lung translocation and antibiotic mediated selection shape the dynamics of Pseudomonas aeruginosa in an ICU patient" was published in the international journal Nature Communications.
Scientists from Oxford University and other institutions have made important discoveries in revealing the emergence and persistence of bacterial antibiotic resistance, and in this article, they have found for the first time that antibiotic-resistant bacteria can migrate from a patient's gut microbiome to the lungs and increase the risk
of fatal infections.

According to the researchers, the results of the study may hopefully help develop life-saving strategies for patients, as they emphasize the importance of preventing pathogenic bacteria from moving from the intestines to other organs and causing serious infections; The study was conducted in the body of a patient carrying Pseudomonas aeruginosa, one of the most common causes of nosocomial infections, and a bacterium that is very good at developing antibiotic resistance, and although it is not generally considered dangerous when embedded in a healthy gut microbiome, it often causes serious lung infections
in hospitalized patients.

During hospitalization, the patient was treated with the antibiotic meropenem for suspected urinary tract infection (UTI), which causes non-resistant bacteria in the gut and lungs to be killed, while antibiotic-resistant Pseudomonas mutants are able to grow and proliferate, and then during antibiotic treatment, they can transfer from the patient's intestines to the lungs and evolve higher levels of
antibiotic resistance in the lungs 。 Researcher Craig MacLean said that hospital-acquired infections are one of the biggest burdens of antibiotic resistance, and the results of this study show that pathogenic bacteria from patients' own gut microbiomes can spread to the lungs and cause infections that are difficult to treat, and the results underscore the importance of eliminating antibiotic-resistant bacteria from the gut microbiome of hospitalized patients, even if they have not yet caused the infection
.

As antibiotic resistance is a growing concern in hospitals, and preventing the spread of resistant bacteria to key organs such as the lungs is particularly important for frail patients, however, the origin of the bacteria that cause these serious infections is difficult to determine, and this study reveals how the gut microbiome acts as a reservoir for antibiotic-resistant pathogens, thereby promoting the transfer of these bacteria to the lungs and potentially causing life-threatening diseases
such as pneumonia 。 The researchers say that eliminating antibiotic-resistant pathogens from the gut microbiome of hospitalized patients may help prevent the development of serious infections, highlighting how antibiotic use can have a profound impact
on bacteria that are not actually targets of antibiotic therapy.

For the first time, scientists have discovered that drug-resistant bacteria may be able to transfer from the intestines to the lungs, increasing the risk of
fatal infections.

Image source: Nature Communications (2022).
DOI:10.
1038/s41467-022-34101-2

In the paper, the researchers tested patients throughout their hospitalization to track the duration of Pseudomonas aeruginosa infection, using a genetic method to create a time-calibrated bacterial family tree that could help analyze the progress and location of infection, as well as its evolution; At the same time, the researchers also found high genetic diversity in the gut, which may indicate that the gut microbiome may be a reservoir
for antibiotic resistance 。 Fortunately, the patient in this case developed an immune response to drug-resistant bacteria in the lungs, which effectively prevented pneumonia caused by infection, however, for many patients in critical conditions (especially in winter), the immune system of the body is weakened, which means that the body is less able to resist the occurrence of infection, antibiotic resistance policies often focus on how to reduce infections from the outside, but it is actually very important to understand the development and spread of bacterial antibiotic resistance in the patient's body
。

The researchers now plan to collect samples from a larger study cohort to assess how often gut-to-lung bacterial metastases occur in susceptible patients; Professor Craig MacLean said it was clear that new ways to tackle the challenges posed by antibiotic-resistant bacteria were needed, and the findings in this paper reveal how gut-lung metastases and antibiotic use combine to drive the spread
of antibiotic resistance in a single patient's body 。 To develop novel interventions to prevent drug-resistant infections, researchers may need new horizons or insights, such as highlighting the potential efficacy of eliminating antibiotic-resistant bacteria such as Pseudomonas aeruginosa from the gut microbiome of hospitalized patients, even if the bacteria do not actually cause infection
.
(Biovalley Bioon.
com)

Original source:

Wheatley, R.
M.
, Caballero, J.
D.
, van der Schalk, T.
E.
et al.
Gut to lung translocation and antibiotic mediated selection shape the dynamics of Pseudomonas aeruginosa in an ICU patient.
Nat Commun 13, 6523 (2022).
doi:10.
1038/s41467-022-34101-2