Abstract

Antibiotics can drive the rapid loss of non-target, phylogenetically diverse microorganisms that inhabit the human gut. This so-called “collateral damage” has myriad consequences for host health and antibiotic mediated changes to the gut microbiota have been implicated in the aetiology of many chronic diseases. To date, studies have largely focused on how antibiotics affect the bacterial fraction of the gut microbiome and their impact on non-bacterial members, including prevalent eukaryal species, such as Blastocystis, remains largely unknown. Here we assessed the prevalence and diversity of Blastocystis in an elderly adult group that were in receipt of antibiotics (n = 86) and an equivalent non-antibiotic treated group (n = 88) using a PCR-based approach. This analysis revealed that although similar subtypes were present in both groups, Blastocystis was significantly less prevalent in the antibiotic-treated group (16%) compared to non-antibiotic treated controls (55%); Fisher’s Exact test, p < 0.0001). Given that antibiotics target structures and molecules of prokaryotic cells to kill or inhibit bacterial populations, the most likely explanation for differences in prevalence between both groups is due to secondary extinctions owing to the potential dependence of Blastocystis on bacteria present in the gut microbiome that were negatively affected by antibiotic treatment. Although further work is required to explore this hypothesis in greater detail, these data clearly show that Blastocystis prevalence in human populations is negatively associated with antibiotic treatment. This finding may be relevant to explaining patterns of variation for this microorganism in different human populations and cohorts of interest.

Highlights

  • Antibiotics are life-saving medicines that play a central role in the fight against infectious disease as well as facilitating many medical practices such as surgeries and chemotherapy (Hutchings et al, 2019)

  • PCR analysis revealed that Blastocystis is significantly less prevalent in the antibiotic-treatment group compared to the control non-antibiotic treated group, Fisher’s Exact test p < 0.0001, see Figure 1A. 14 out of 86, or 16% of individuals were positive for Blastocystis in the ABX+ compared to 48 out of 88, or 55% in the ABX- control group

  • It is unlikely that the antibiotics used in this study are directly killing Blastocystis populations, but rather the reduced prevalence observed in the ABX+ group is due to indirect effects of antibiotic treatment i.e. antibiotics are killing or inhibiting bacterial populations that Blastocystis potentially requires for colonisation, growth and persistence in the human gut

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Summary

Introduction

Antibiotics are life-saving medicines that play a central role in the fight against infectious disease as well as facilitating many medical practices such as surgeries and chemotherapy (Hutchings et al, 2019). An understanding of how antibiotics affect the ecology and evolution on the human gut microbiota has been the subject of a multitude of different in vitro, in silico and in vivo studies (Dethlefsen and Relman, 2011; Candon et al, 2015; Shaw et al, 2019; Chng et al, 2020; Ramirez et al, 2020; Pennycook and Scanlan, 2021) To date, these studies have largely focused on how antibiotics affect the bacterial fraction of the community, with some exceptions (Górska et al, 2018; Seelbinder et al, 2020; Haak et al, 2021). The extent to which antibiotics impact on the prevalence and diversity of ecologically and clinically relevant species of intestinal microbial protists, such as Blastocystis, remains largely unknown

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