Recovery of the gut microbiome following enteric infection and persistence of antimicrobial resistance genes in specific microbial hosts

Abstract

Enteric pathogens cause widespread foodborne illness and are increasingly found to harbor antimicrobial resistance. The ecological impact of these pathogens on the human gut microbiome and resistome, however, has yet to be fully elucidated. This study applied shotgun metagenome sequencing to stools from 60 patients (cases) with enteric bacterial infections for comparison to stools collected from the same patients post-recovery (follow-ups). Overall, the case samples harbored more antimicrobial resistance genes (ARGs) and had greater resistome diversity than the follow-up samples (p<0.001), while follow-ups had much more diverse microbiomes (p<0.001). Although cases were primarily defined by genera Escherichia, Salmonella, and Shigella along with ARGs for multi-compound and multidrug resistance, follow-ups had a greater abundance of Bacteroidetes and Firmicutes phyla and genes for tetracycline, macrolides, lincosamides, and streptogramins (MLS), and aminoglycoside resistance. A host-tracking analysis revealed that Escherichia was the primary carrier of ARGs in both cases and follow-ups, with a greater abundance occurring during infection. Eleven distinct extended spectrum beta-lactamases (ESBLs) were identified during infection, some of which appear to be lost or transferred to different microbial hosts upon recovery. The increasing incidence of disease caused by foodborne pathogens, coupled with their evolving role in harboring and transferring antimicrobial resistance determinants within communities, justifies further examination of the repercussions of enteric infection on human gut ecology.