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[Characteristics of Gut Microbiota Changes and Their Relationship with Infectious Complications During Induction
Quan-Lei Zhang1, Li-Li Dong2, Lin-Lin Zhang2
1Chinese PLA Medical School, Beijing 100853, China.
Objective:
To investigate the characteristics of gut microbiota changes in patients with acute myeloid leukemia (AML) undergoing induction chemotherapy and to explore the relationship between infectious complications and gut microbiota.
Methods:
Fecal samples were collected from 37 newly diagnosed AML patients at four time points: before induction chemotherapy, during chemotherapy, during the neutropenic phase, and during the recovery phase. Metagenomic sequencing was used to analyze the dynamic changes in gut microbiota. Correlation analyses were conducted to assess the relationship between changes in gut microbiota and the occurrence of infectious complications.
Results:
During chemotherapy, the gut microbiota α-diversity (Shannon index) of AML patients exhibited significant fluctuations. Specifically, the diversity decreased significantly during induction chemotherapy, further declined during the neutropenic phase (P < 0.05, compared to baseline), and gradually recovered during the recovery phase, though not fully returning to baseline levels.The abundances of beneficial bacteria, such as Firmicutes and Bacteroidetes, gradually decreased during chemotherapy, whereas the abundances of opportunistic pathogens, including Enterococcus, Klebsiella, and Escherichia coli, progressively increased.Analysis of the dynamic changes in gut microbiota of seven patients with bloodstream infections revealed that the bloodstream infection pathogens could be detected in the gut microbiota of the corresponding patients, with their abundance gradually increasing during the course of infection. This finding suggests that bloodstream infections may be associated with opportunistic pathogens originating from the gut microbiota.Compared to non-infected patients, the baseline samples of infected patients showed a significantly lower relative abundance of Bacteroidetes (P < 0.05). Regression analysis indicated that Bacteroidetes abundance is an independent predictive factor for infectious complications (P < 0.05, OR =13.143).
Conclusion:
During induction chemotherapy in AML patients, gut microbiota α-diversity fluctuates significantly, and the abundance of opportunistic pathogens increase, which may be associated with bloodstream infections. Patients with lower baseline Bacteroidetes abundance are more prone to infections, and its abundance can serve as an independent predictor of infectious complications.
Insights
During induction chemotherapy for acute myeloid leukemia (AML), gut microbiota diversity decreases, and opportunistic pathogens increase, potentially leading to bloodstream infections. Lower baseline Bacteroidetes levels predict infection risk.
Area of Science:
- Microbiome research
- Oncology
- Infectious disease
Context:
- Acute myeloid leukemia (AML) patients undergoing induction chemotherapy experience significant physiological changes.
- The gut microbiota plays a crucial role in host health and immune function.
- Chemotherapy-induced alterations in gut microbiota are increasingly recognized as a factor in patient outcomes.
Purpose:
- To characterize dynamic gut microbiota shifts during AML induction chemotherapy.
- To investigate the association between gut microbial composition and infectious complications.
- To identify microbial biomarkers for predicting infection risk in AML patients.
Summary:
- Gut microbiota alpha-diversity (Shannon index) significantly decreased during induction chemotherapy and neutropenia in AML patients, with partial recovery.
- Abundances of beneficial bacteria (Firmicutes, Bacteroidetes) declined, while opportunistic pathogens (Enterococcus, Klebsiella, E. coli) increased.
- Bloodstream infection pathogens were detected in the gut microbiota of infected patients, suggesting a gut origin. Lower baseline Bacteroidetes abundance (<0.05) was linked to increased infection risk and identified as an independent predictor (OR=13.143).
Impact:
- Findings highlight the profound impact of chemotherapy on the gut microbiome in AML.
- The study identifies specific microbial changes and a potential biomarker (Bacteroidetes) for infection risk stratification.
- Results may inform targeted interventions to modulate the gut microbiota and reduce infectious complications in AML patients.
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