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Impact of bacterial infections and spontaneous bacterial peritonitis prophylaxis on phage-bacterial dynamics in

Jasmohan S Bajaj1, Marcela Peňa Rodriguez2, Andrew Fagan1

  • 1Division of Gastroenterology, Hepatology and NutritionVirginia Commonwealth University and Central Virginia Veterans Healthcare System Medical CenterVirginiaUSA.

Hepatology (Baltimore, Md.)
|May 13, 2022
PubMed
Abstract

Insights

In cirrhosis patients, gut bacteria and phages shift during infection and spontaneous bacterial peritonitis (SBP) prophylaxis. These changes impact bacterial-phage interactions, particularly concerning Escherichia coli and Enterococcus faecium.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Infectious Diseases

Background:

  • Cirrhosis alters gut microbiota, including bacteria and phages.
  • The role of these alterations in infections and spontaneous bacterial peritonitis (SBP) prophylaxis remains unclear.

Purpose of the Study:

  • To determine metagenomic changes in gut bacteria and phages.
  • To analyze bacteria-phage linkages centered around Gram-negative and Gram-positive pathobionts in cirrhosis patients with or without infections or SBP prophylaxis.

Main Methods:

  • Stool samples analyzed for bacterial and phage metagenomics from uninfected and infected cirrhosis patients.
  • Patients matched by Model for End-Stage Liver Disease (MELD) score.
  • Correlation networks analyzed for bacteria-phage linkages, focusing on Escherichia coli and Enterococcus faecium.

Main Results:

  • Infected patients showed higher levels of Enterobacteriaceae, Enterococcus, Streptococcus spp., and Escherichia phages.
  • Bacteria-phage correlation networks were more complex in infected patients.
  • Spontaneous bacterial peritonitis (SBP) prophylaxis increased Gram-positive bacteria and altered phage-bacterial correlations around E. coli and E. faecium.

Conclusions:

  • Cirrhosis patients exhibit significant changes in phage-bacterial linkages during infection and SBP prophylaxis.
  • SBP prophylaxis enriches Enterococcus faecium-centered linkages but collapses Escherichia coli-centered correlations.

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