A peptidoglycan storm caused by β-lactam antibiotic's action on host microbiota drives Candida albicans infection

The commensal fungus Candida albicans often causes life-threatening infections in patients who are immunocompromised with high mortality. A prominent but poorly understood risk factor for the C. albicans commensalpathogen transition is the use of broad-spectrum antibiotics. Here, we report that beta -lactam antibiotics cause bacteria to release significant quantities of peptidoglycan fragments that potently induce the invasive hyphal growth of C. albicans. We identify several active peptidoglycan subunits, including tracheal cytotoxin, a molecule produced by many Gram-negative bacteria, and fragments purified from the cell wall of Gram-positive Staphylococcus aureus. Feeding mice with beta -lactam antibiotics causes a peptidoglycan storm that transforms the gut from a niche usually restraining C. albicans in the commensal state to promoting invasive growth, leading to systemic dissemination. Our findings reveal a mechanism underlying a significant risk factor for C. albicans infection, which could inform clinicians regarding future antibiotic selection to minimize this deadly disease incidence. A risk factor for invasive Candida albicans infection is the use of broad-spectrum antibiotics, but the reasons are poorly understood. Here, the authors show in mice that beta -lactam antibiotics cause commensal bacteria to release peptidoglycan fragments that induce the invasive hyphal growth of C. albicans, leading to systemic dissemination.

Automated summary

Broad-spectrum antibiotics can induce the release of peptidoglycan fragments by commensal bacteria, leading to the invasive growth of C. albicans and systemic dissemination, which is a significant risk factor for infection.