Host-mediated sugar oxidation promotes post-antibiotic pathogen expansion

Abstract

Changes in the gut microbiota may underpin many human diseases, but the mechanisms that are responsible for altering microbial communities remain poorly understood. Antibiotic usage elevates the risk of contracting gastroenteritis caused by Salmonella enterica serovars 1, increases the duration for which patients shed the pathogen in their feces and may on occasion produce a bacteriologic and symptomatic relapse 2,3. These antibiotic-induced changes in the gut microbiota can be studied in mice, where the disruption of a balanced microbial community by treatment with streptomycin leads to an expansion of S. enterica serovars in the large bowel 4. However, the mechanisms by which streptomycin treatment drives an expansion of S. enterica serovars are not fully resolved. Here we show that host-mediated oxidation of galactose and glucose promotes post-antibiotic expansion of S. enterica serovar Typhimurium (S. Typhimurium). By elevating expression of the gene encoding inducible nitric oxide synthase (iNOS) in the cecal mucosa, streptomycin treatment increased post-antibiotic availability of the oxidation products galactarate and glucarate in the murine cecum. S. Typhimurium utilized galactarate and glucarate within the gut lumen of streptomycin pre-treated mice and genetic ablation of the respective catabolic pathways reduced its competitiveness. Our results identify a host-mediated oxidation of carbohydrates in the gut as a novel mechanism for post-antibiotic pathogen expansion.