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High-resolution mycobiota analysis reveals dynamic intestinal translocation preceding invasive candidiasis
- Source :
- Nature Medicine. 26:59-64
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- The intestinal microbiota is a complex community of bacteria, archaea, viruses, protists and fungi1,2. Although the composition of bacterial constituents has been linked to immune homeostasis and infectious susceptibility3-7, the role of non-bacterial constituents and cross-kingdom microbial interactions in these processes is poorly understood2,8. Fungi represent a major cause of infectious morbidity and mortality in immunocompromised individuals, although the relationship of intestinal fungi (that is, the mycobiota) with fungal bloodstream infections remains undefined9. We integrated an optimized bioinformatics pipeline with high-resolution mycobiota sequencing and comparative genomic analyses of fecal and blood specimens from recipients of allogeneic hematopoietic cell transplant. Patients with Candida bloodstream infection experienced a prior marked intestinal expansion of pathogenic Candida species; this expansion consisted of a complex dynamic between multiple species and subspecies with a stochastic translocation pattern into the bloodstream. The intestinal expansion of pathogenic Candida spp. was associated with a substantial loss in bacterial burden and diversity, particularly in the anaerobes. Thus, simultaneous analysis of intestinal fungi and bacteria identifies dysbiosis states across kingdoms that may promote fungal translocation and facilitate invasive disease. These findings support microbiota-driven approaches to identify patients at risk of fungal bloodstream infections for pre-emptive therapeutic intervention.
- Subjects :
- 0301 basic medicine
Mycobiota
medicine.medical_treatment
Chromosomal translocation
Hematopoietic stem cell transplantation
Biology
General Biochemistry, Genetics and Molecular Biology
Microbiology
Feces
03 medical and health sciences
0302 clinical medicine
Species Specificity
medicine
Humans
Transplantation, Homologous
Candidiasis, Invasive
Gene
Candida
Cross Infection
Bacteria
Hematopoietic Stem Cell Transplantation
General Medicine
medicine.disease
biology.organism_classification
Intestines
Transplantation
030104 developmental biology
030220 oncology & carcinogenesis
Dysbiosis
Mycobiome
Subjects
Details
- ISSN :
- 1546170X and 10788956
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Nature Medicine
- Accession number :
- edsair.doi.dedup.....1cd19466968a55d75c8eaeb04f138ba9