Gut microbiome dynamics and Enterobacterales infection in liver transplant recipients: A prospective observational study

• DOI: 10.1016/j.jhepr.2024.101039
• Publication Date: 2024-02-12T07:14:42Z
• Authors: Federica D’Amico; Matteo Rinaldi; Renato Pascale; Marco Fabbrini; Maria Cristina Mo...; Antonio Siniscalchi; Cristiana Laici; Simona Coladonato; Matteo Ravaioli; Matteo Cescon; Simone Ambretti; Pierluigi Viale; Patrizia Brigidi; Silvia Turroni; Maddalena Giannella
• Keywords: Fecal bacteriotherapy

Background and AimsTo investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection non-CRE development within 2 months after liver transplant (LT).MethodsA single-center, prospective study was performed patients undergoing LT from November 2018 January 2020. GM profiled by 16S rRNA amplicon sequencing of rectal swab taken on the day transplantation fecal samples collected weekly until 1 month LT. A subset subjected shotgun metagenomics, including resistome dynamics. The primary endpoint explore changes following groups: i) carriers developing (CRE_I); ii) not (CRE_UI); iii) microbial (INF); iv) (NEG).ResultsOverall, 97 were enrolled 91 provided samples. Of these, 5, 9, 22 55 classified as CRE_I, CRE_UI, INF NEG, respectively. CRE_I showed an immediate sustained post-LT decrease alpha diversity, with depletion structure gradual overrepresentation Klebsiella Enterococcus. proportions significantly higher than NEG even before LT, early marker subsequent infection. CRE_UI had a more stable diverse GM, whose compositional tended overlap those patients.ConclusionsGM profiling could improve patient stratification risk prediction guide GM-based intervention strategies reduce infectious complications overall prognosis.