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Updated: Jan 26, 2026
Isolation and Transplantation of Hematopoietic Stem Cells HSCs
Published on: February 25, 2007
Gut resistome plasticity in pediatric patients undergoing hematopoietic stem cell transplantation
Federica D'Amico1, Matteo Soverini1, Daniele Zama2
1Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, Bologna, 40126, Italy.
Insights
Pediatric patients undergoing stem cell transplants with Graft-versus-Host Disease show increased gut antibiotic resistance genes. This highlights the need to monitor the gut resistome for better infection treatment post-transplant.
Area of Science:
- Microbiology
- Immunology
- Hematology
Background:
- The gut microbiome is a reservoir for antimicrobial resistance (AMR).
- AMR in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) impacts mortality.
- Understanding gut resistome dynamics post-HSCT is crucial.
Purpose of the Study:
- To explore the gut resistome dynamics in pediatric HSCT patients.
- To investigate the association between acute Graft-versus-Host Disease (aGvHD) and gut resistome expansion.
- To identify specific antibiotic resistance patterns in aGvHD patients.
Main Methods:
- Shotgun metagenomics was employed to analyze the gut microbiome.
- Eight pediatric HSCT patients were studied, with half developing aGvHD.
- Resistome patterns were analyzed before and after HSCT.
Main Results:
- Patients with aGvHD exhibited significant post-HSCT expansion of their gut resistome.
- New antibiotic resistance genes were acquired, and pre-existing ones were consolidated in aGvHD patients.
- The aGvHD-associated resistome bloom included multidrug resistance and resistance to macrolides, aminoglycosides, tetracyclines, and beta-lactams.
Conclusions:
- Acute Graft-versus-Host Disease is linked to an expanded gut resistome in pediatric HSCT patients.
- The observed resistance patterns extend beyond administered antibiotics, indicating broader AMR implications.
- Mapping the gut resistome is essential for optimizing anti-infective strategies in HSCT recipients.
Abstract:
The gut microbiome of pediatric patients undergoing allo-hematopoietic stem cell transplantation (HSCT) has recently been considered as a potential reservoir of antimicrobial resistance, with important implications in terms of patient mortality rate. By means of shotgun metagenomics, here we explored the dynamics of the gut resistome - i.e. the pattern of antibiotic resistance genes provided by the gut microbiome - in eight pediatric patients undergoing HSCT, half of whom developed acute Graft-versus-Host Disease (aGvHD). According to our findings, the patients developing aGvHD are characterized by post-HSCT expansion of their gut resistome, involving the acquisition of new resistances, as well as the consolidation of those already present before HSCT. Interestingly, the aGvHD-associated bloom in resistome diversity is not limited to genes coding for resistance to the antibiotics administered along the therapeutic course, but rather involves a broad pattern of different resistance classes, including multidrug resistance, as well as resistance to macrolides, aminoglycosides, tetracyclines and beta-lactams. Our data stress the relevance of mapping the gut resistome in HSCT pediatric patients to define the most appropriate anti-infective treatment post HSCT.
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