Contribution of the Oral and Gastrointestinal Microbiomes to Bloodstream Infections in Leukemia Patients

Bloodstream infections (BSIs) pose a significant mortality risk for acute myeloid leukemia (AML) patients. It has been previously reported that intestinal domination (>30% relative abundance [RA] attributed to a single taxon) with the infecting taxa often precedes BSI in stem cell transplant pati...

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Published in:Microbiology spectrum 2023-06, Vol.11 (3), p.e0041523
Main Authors: McMahon, Stephanie, Sahasrabhojane, Pranoti, Kim, Jiwoong, Franklin, Samantha, Chang, Chia-Chi, Jenq, Robert R, Hillhouse, Andrew E, Shelburne, Samuel A, Galloway-Peña, Jessica
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
bacteremia
Bacteremia - microbiology
Clinical Microbiology
colonization
Gastrointestinal Microbiome - genetics
Humans
intestinal domination
leukemia
Leukemia, Myeloid, Acute - complications
Leukemia, Myeloid, Acute - drug therapy
Microbiota
oral microbiome
Research Article
RNA, Ribosomal, 16S - genetics
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Summary:Bloodstream infections (BSIs) pose a significant mortality risk for acute myeloid leukemia (AML) patients. It has been previously reported that intestinal domination (>30% relative abundance [RA] attributed to a single taxon) with the infecting taxa often precedes BSI in stem cell transplant patients. Using 16S rRNA amplicon sequencing, we analyzed oral and stool samples from 63 AML patients with BSIs to determine the correlation between the infectious agent and microbiome composition. Whole-genome sequencing and antimicrobial susceptibilities were performed on all BSI isolates. Species-level detection of the infectious agent and presence of antibiotic resistance determinants in the stool ( , , , and ) were confirmed via digital droplet PCR (ddPCR). Individuals with Escherichia coli (stool  30% abundance by 16S rRNA sequencing). In this study, we sought to better understand how domination and abundance levels of the oral and gut microbiome relate to bacteremia occurrence in acute myeloid leukemia patients. We conclude that analyses of both oral and stool samples can help identify BSI and antimicrobial resistance determinants, thus potentially improving the timing and tailoring of antibiotic treatment strategies for high-risk patients.
ISSN:2165-0497
2165-0497
DOI:10.1128/spectrum.00415-23