期刊
CELL HOST & MICROBE
卷 30, 期 7, 页码 1020-+出版社
CELL PRESS
DOI: 10.1016/j.chom.2022.04.013
关键词
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资金
- Division of Intramural Research of the National Institute of Allergy & Infectious Disease
- National Human Genome Research Institute
- National Cancer Institute
- NIH Clinical Center
Antibiotics increase susceptibility to invasive candidiasis by impairing antifungal immunity and increasing the risk of systemic bacterial co-infection. Vancomycin has a similar effect by reducing the frequency of Th17 cells in the gut. In humans, antibiotics are associated with an increased risk of invasive candidiasis and death.
Antibiotics are a modifiable iatrogenic risk factor for the most common human nosocomial fungal infection, invasive candidiasis, yet the underlying mechanisms remain elusive. We found that antibiotics enhanced the susceptibility to murine invasive candidiasis due to impaired lymphocyte-dependent IL-17A- and GM- CSFmediated antifungal immunity within the gut. This led to non-inflammatory bacterial escape and systemic bacterial co-infection, which could be ameliorated by IL-17A or GM-CSF immunotherapy. Vancomycin alone similarly enhanced the susceptibility to invasive fungal infection and systemic bacterial co-infection. Mechanistically, vancomycin reduced the frequency of gut Th17 cells associated with impaired proliferation and RORgt expression. Vancomycin's effects on Th17 cells were indirect, manifesting only in vivo in the presence of dysbiosis. In humans, antibiotics were associated with an increased risk of invasive candidiasis and death after invasive candidiasis. Our work highlights the importance of antibiotic stewardship in protecting vulnerable patients from life-threatening infections and provides mechanistic insights into a controllable iatrogenic risk factor for invasive candidiasis.
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