Aim: The aim of the study was to assess the influence of non-antibiotic medicationcontributing to MDRO colonisation.Methods: Three hundred twenty-four patients with AD and ACLF admitted to the... Show moreAim: The aim of the study was to assess the influence of non-antibiotic medicationcontributing to MDRO colonisation.Methods: Three hundred twenty-four patients with AD and ACLF admitted to the ICUof Frankfurt University Hospital with MDRO screening were included. Regressionmodels were performed to identify drugs associated with MDRO colonisation.Another cohort (n = 129) from Barcelona was included to validate. A third multi-centre cohort (n = 203) with metagenomic sequencing data of stool was included todetect antibiotic resistance genes.Results: A total of 97 patients (30%) were identified to have MDRO colonisation and35 of them (11%) developed MDRO infection. Patients with MDRO colonisation hadsignificantly higher risk of MDRO infection than those without (p = 0.0098). Apartfrom antibiotic therapy (odds ratio (OR) 2.91, 95%-confidence interval (CI) 1.82–4.93,p < 0.0001), terlipressin therapy in the previous 14 days was the only independentcovariate associated with MDRO colonisation in both cohorts, the overall (OR 9.47,95%-CI 2.96–30.23, p < 0.0001) and after propensity score matching (OR 5.30, 95%-CI 1.22–23.03, p = 0.011). In the second cohort, prior terlipressin therapy was a riskfactor for MDRO colonisation (OR 2.49, 95% CI 0.911–6.823, p = 0.075) and associ-ated with risk of MDRO infection during follow-up (p = 0.017). The validation cohortdemonstrated that antibiotic inactivation genes were significantly associated withterlipressin administration (p = 0.001).Conclusions: Our study reports an increased risk of MDRO colonisation in patientswith AD or ACLF, who recently received terlipressin therapy, while other commonlyprescribed non-antibiotic co-medications had negligible influence. Future prospec-tive trials are needed to confirm these results. Show less
Bahram, M.; Hildebrand, F.; Forslund, S.K.; Anderson, J.L.; Soudzilovskaia, N.A.; Bodegom, P.M. van; ... ; Bork, P. 2018
Soils harbour some of the most diverse microbiomes on Earth and are essential for both nutrient cycling and carbon storage. To understand soil functioning, it is necessary to model the global... Show moreSoils harbour some of the most diverse microbiomes on Earth and are essential for both nutrient cycling and carbon storage. To understand soil functioning, it is necessary to model the global distribution patterns and functional gene repertoires of soil microorganisms, as well as the biotic and environmental associations between the diversity and structure of both bacterial and fungal soil communities(1-4). Here we show, by leveraging metagenomics and metabarcoding of global topsoil samples (189 sites, 7,560 subsamples), that bacterial, but not fungal, genetic diversity is highest in temperate habitats and that microbial gene composition varies more strongly with environmental variables than with geographic distance. We demonstrate that fungi and bacteria show global niche differentiation that is associated with contrasting diversity responses to precipitation and soil pH. Furthermore, we provide evidence for strong bacterial-fungal antagonism, inferred from antibiotic-resistance genes, in topsoil and ocean habitats, indicating the substantial role of biotic interactions in shaping microbial communities. Our results suggest that both competition and environmental filtering affect the abundance, composition and encoded gene functions of bacterial and fungal communities, indicating that the relative contributions of these microorganisms to global nutrient cycling varies spatially. Show less
Deghou, S.; Zeller, G.; Iskar, M.; Driessen, M.; Castillo, M.; Noort, V. van; Bork, P. 2016
