4.7 Article

Antimicrobial Resistance Gene Prevalence in a Population of Patients with Advanced Dementia Is Related to Specific Pathobionts

期刊

ISCIENCE
卷 23, 期 3, 页码 -

出版社

CELL PRESS
DOI: 10.1016/j.isci.2020.100905

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资金

  1. National Institute of General Medical Sciences [P20GM121344]
  2. Centers for Disease Control and Prevention [200-2016-91939]
  3. National Institutes of Allergy and Infectious Diseases [K24AI119158]
  4. National Institute on Aging [R01AG032982]
  5. Millennium Nucleus for Collaborative Research on Bacterial Resistance (MICROB-R) - Millennium Scientific Initiative of the Ministry of Economy, Development and Tourism (Chile)

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Long-term care facilities are significant reservoirs of antimicrobial-resistant organisms, and patients with advanced dementia are particularly vulnerable to multidrug-resistant organism (MDRO) acquisition and antimicrobial overuse. In this study, we longitudinally examined a group of patients with advanced dementia using metagenomic sequencing. We found significant inter- and intra-subject heterogeneity in microbiota composition, suggesting temporal instability. We also observed a link between the antimicrobial resistance gene density in a sample and the relative abundances of several pathobionts, particularly Escherichia coli, Proteus mirabilis, and Enterococcus faecalis, and used this relationship to predict resistance gene density in samples from additional subjects. Furthermore, we used metagenomic assembly to demonstrate that these pathobionts had higher resistance gene content than many gut commensals. Given the frequency and abundances at which these pathobionts were found in this population and the underlying vulnerability to MDRO of patients with advanced dementia, attention to microbial blooms of these species may be warranted.

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