Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features
Abstract Background The impact of the fecal multidrug-resistant organism (MDRO) carriage on the gut microbiota, metabolite alterations, and cirrhosis-related complications remains unclear. Methods Eighty-eight patients with cirrhosis and 22 healthy volunteers were analyzed for plasma metabolites, fe...
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BMC
2025-05-01
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| Series: | Gut Pathogens |
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| Online Access: | https://doi.org/10.1186/s13099-025-00706-3 |
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| author | Pei-Shan Wu Pei-Chang Lee Tien-En Chang Yun-Cheng Hsieh Chi-Wei Huang Chao-Hsiung Lin Yi-Long Huang Yi-Tsung Lin Teh-Ia Huo Bernd Schnabl Kuei-Chuan Lee Ming-Chih Hou |
| author_facet | Pei-Shan Wu Pei-Chang Lee Tien-En Chang Yun-Cheng Hsieh Chi-Wei Huang Chao-Hsiung Lin Yi-Long Huang Yi-Tsung Lin Teh-Ia Huo Bernd Schnabl Kuei-Chuan Lee Ming-Chih Hou |
| author_sort | Pei-Shan Wu |
| collection | DOAJ |
| description | Abstract Background The impact of the fecal multidrug-resistant organism (MDRO) carriage on the gut microbiota, metabolite alterations, and cirrhosis-related complications remains unclear. Methods Eighty-eight patients with cirrhosis and 22 healthy volunteers were analyzed for plasma metabolites, fecal MDROs, and microbiota composition. The fecal bacterial and fungal composition was assessed using 16S ribosomal RNA and internal transcribed spacer sequencing, whereas plasma metabolomic analysis was evaluated via untargeted liquid chromatography-mass spectrometry. Predictors of cirrhosis-related outcomes, risk factors for MDRO carriage, and microbiota-metabolite correlations were analyzed. Results Fecal MDRO carriage was detected in 33% of patients with cirrhosis. MDRO carriers had a higher risk of hepatic encephalopathy (HE) compared to non-carriers (20.7% vs. 3.2%, p = 0.008). Patients carrying MDROs had higher plasma lipopolysaccharide (LPS) levels, and both elevated LPS and MDRO carriage independently predicted HE occurrence within 1 year. Compared with non-carriers, MDRO carriers had higher fecal bacterial and fungal burdens and exhibited different gut microbiota compositions, characterized by increased Streptococcus salivarius and enrichment of Saccharomycetes and Candida albicans. Thirty-one metabolites differed significantly among healthy controls, and patients with cirrhosis, with and without MDRO carriage. Six metabolites were significantly correlated with specific microbial taxa in MDRO carriers. Isoaustin, a fungal-derived metabolite, was significantly elevated in MDRO carriers with HE. Conclusions Fecal MDRO carriage was associated with endotoxemia, altered gut microbiota, metabolic changes, and a higher risk of HE. It’s worthy to monitor fecal MDRO colonization in cirrhosis. |
| format | Article |
| id | doaj-art-3a0dc91de85b4827bf740c8419f175cb |
| institution | DOAJ |
| issn | 1757-4749 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Gut Pathogens |
| spelling | doaj-art-3a0dc91de85b4827bf740c8419f175cb2025-08-20T03:10:13ZengBMCGut Pathogens1757-47492025-05-0117111710.1186/s13099-025-00706-3Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite featuresPei-Shan Wu0Pei-Chang Lee1Tien-En Chang2Yun-Cheng Hsieh3Chi-Wei Huang4Chao-Hsiung Lin5Yi-Long Huang6Yi-Tsung Lin7Teh-Ia Huo8Bernd Schnabl9Kuei-Chuan Lee10Ming-Chih Hou11Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalEudaiBiome, Co, LtdDepartment of Life Sciences and Institute of Genome Sciences, National Yang Ming Chiao Tung UniversityCenter for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung UniversityDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDepartment of Medicine, University of California San DiegoDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General HospitalAbstract Background The impact of the fecal multidrug-resistant organism (MDRO) carriage on the gut microbiota, metabolite alterations, and cirrhosis-related complications remains unclear. Methods Eighty-eight patients with cirrhosis and 22 healthy volunteers were analyzed for plasma metabolites, fecal MDROs, and microbiota composition. The fecal bacterial and fungal composition was assessed using 16S ribosomal RNA and internal transcribed spacer sequencing, whereas plasma metabolomic analysis was evaluated via untargeted liquid chromatography-mass spectrometry. Predictors of cirrhosis-related outcomes, risk factors for MDRO carriage, and microbiota-metabolite correlations were analyzed. Results Fecal MDRO carriage was detected in 33% of patients with cirrhosis. MDRO carriers had a higher risk of hepatic encephalopathy (HE) compared to non-carriers (20.7% vs. 3.2%, p = 0.008). Patients carrying MDROs had higher plasma lipopolysaccharide (LPS) levels, and both elevated LPS and MDRO carriage independently predicted HE occurrence within 1 year. Compared with non-carriers, MDRO carriers had higher fecal bacterial and fungal burdens and exhibited different gut microbiota compositions, characterized by increased Streptococcus salivarius and enrichment of Saccharomycetes and Candida albicans. Thirty-one metabolites differed significantly among healthy controls, and patients with cirrhosis, with and without MDRO carriage. Six metabolites were significantly correlated with specific microbial taxa in MDRO carriers. Isoaustin, a fungal-derived metabolite, was significantly elevated in MDRO carriers with HE. Conclusions Fecal MDRO carriage was associated with endotoxemia, altered gut microbiota, metabolic changes, and a higher risk of HE. It’s worthy to monitor fecal MDRO colonization in cirrhosis.https://doi.org/10.1186/s13099-025-00706-3Multidrug resistant organismsCirrhosis-associated complicationsMicrobiotaMetaboliteHepatic encephalopathy |
| spellingShingle | Pei-Shan Wu Pei-Chang Lee Tien-En Chang Yun-Cheng Hsieh Chi-Wei Huang Chao-Hsiung Lin Yi-Long Huang Yi-Tsung Lin Teh-Ia Huo Bernd Schnabl Kuei-Chuan Lee Ming-Chih Hou Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features Gut Pathogens Multidrug resistant organisms Cirrhosis-associated complications Microbiota Metabolite Hepatic encephalopathy |
| title | Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features |
| title_full | Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features |
| title_fullStr | Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features |
| title_full_unstemmed | Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features |
| title_short | Fecal carriage of multidrug-resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis: insights from gut microbiota and metabolite features |
| title_sort | fecal carriage of multidrug resistant organisms increases the risk of hepatic encephalopathy in patients with cirrhosis insights from gut microbiota and metabolite features |
| topic | Multidrug resistant organisms Cirrhosis-associated complications Microbiota Metabolite Hepatic encephalopathy |
| url | https://doi.org/10.1186/s13099-025-00706-3 |
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