Ceftriaxone Administration Disrupts Intestinal Homeostasis, Mediating Noninflammatory Proliferation and Dissemination of Commensal Enterococci

Infect Immun. 2018 Nov 20;86(12):e00674-18. doi: 10.1128/IAI.00674-18. Print 2018 Dec.

Abstract

Enterococci are Gram-positive commensals of the mammalian intestinal tract and harbor intrinsic resistance to broad-spectrum cephalosporins. Disruption of colonization resistance in humans by antibiotics allows enterococci to proliferate in the gut and cause disseminated infections. In this study, we used Enterococcus faecalis (EF)-colonized mice to study the dynamics of enterococci, commensal microbiota, and the host in response to systemic ceftriaxone administration. We found that the mouse model recapitulates intestinal proliferation and dissemination of enterococci seen in humans. Employing a ceftriaxone-sensitive strain of enterococci (E. faecalis JL308), we showed that increased intestinal abundance is critical for the systemic dissemination of enterococci. Investigation of the impact of ceftriaxone on the mucosal barrier defenses and integrity suggested that translocation of enterococci across the intestinal mucosa was not associated with intestinal pathology or increased permeability. Ceftriaxone-induced alteration of intestinal microbial composition was associated with transient increase in the abundance of multiple bacterial operational taxonomic units (OTUs) in addition to enterococci, for example, lactobacilli, which also disseminated to the extraintestinal organs. Collectively, these results emphasize that ceftriaxone-induced disruption of colonization resistance and alteration of mucosal homeostasis facilitate increased intestinal abundance of a limited number of commensals along with enterococci, allowing their translocation and systemic dissemination in a healthy host.

Keywords: Enterococcus; Lactobacillus; antibiotic resistance; bacterial dissemination; ceftriaxone; intestinal colonization; intestinal homeostasis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / adverse effects*
  • Bacterial Translocation
  • Ceftriaxone / adverse effects*
  • Enterococcus faecalis
  • Gastrointestinal Microbiome
  • Gram-Positive Bacterial Infections
  • Homeostasis / drug effects*
  • Intestines / drug effects*
  • Intestines / microbiology
  • Intestines / physiopathology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Symbiosis / drug effects*

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone