Abstract

Background: Urinary levels of small molecules generated by the gut microbiota (GMB) constitute potential biomarkers for the state of the GMB. Such metabolites include numerous small phenolic molecules linked to anaerobic bacteria, particularly Clostridium species. Due to multiple technical challenges, however, the relationship between these chemicals and the GMB remains poorly characterized. Improved, high-performance liquid chromatography-mass spectrometry (LC-MS)-based metabolomic analysis can now reliably separate and quantify low levels of multiple small phenolic molecules and their structural isomers.Methods: CF-1 (female mice) were treated over 2 consecutive days with either i) vehicle, ii) one of 2 different antibiotic regimens (clindamycin or piperacillin/tazobactam) known to inhibit intestinal anaerobes and promote colonization by Clostridium difficile and other pathogens or iii) an antibiotic (aztreonam) that suppresses facultative Gram-negative bacteria but not enterococci or anaerobes and does not promote pathogen colonization Urine collected 24 hours after the last treatment was analyzed by LC-MS.Results: We identified over 25 compounds, many of which had not been previously reported in mouse urine. Eleven small phenolic molecules showed significant antibiotic-related changes. Urinary levels of the hydroxyphenylpropionic acids were suppressed by clindamycin and piperacillin/tazobactam treatment, but were elevated in aztreonam-treated mice. In addition, aztreonam treatment was associated with elevated levels of the dihydroxyhydrocinnamic acids.Conclusions: Profiles of differential changes in urinary small phenolic molecules may provide an index of anaerobic bacterial species in the GMB and could prove useful in monitoring susceptibility to overgrowth of pathogens such as C. difficile.

Highlights

  • Numerous small molecules (< 2,000 Da) produced by the gut microbiota (GMB) [1, 2] enter the systemic circulation and are excreted in urine [3]

  • We recently demonstrated that several GMB-associated urinary chemicals were affected by antibiotic treatment in a mouse model of colonization www.PaiJournal.com resistance [8]

  • Piperacillin/tazobactam treatment resulted in statistically significant reductions in 3,2-HPPA and 3,4-HPPA

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Summary

Introduction

Numerous small molecules (< 2,000 Da) produced by the gut microbiota (GMB) [1, 2] enter the systemic circulation and are excreted in urine [3] Identifying these chemicals and clarifying their underlying kinetics may facilitate development of biomarkers relevant to GMB-sensitive diseases. Alteration of the GMB by antibiotics may facilitate colonization by and overgrowth of healthcare-associated pathogens such as Clostridium difficile and vancomycin-resistant enterococci (VRE) [4,5,6]. Urinary levels of small molecules generated by the gut microbiota (GMB) constitute potential biomarkers for the state of the GMB. Such metabolites include numerous small phenolic molecules linked to anaerobic bacteria, Clostridium species. High-performance liquid chromatography-mass spectrometry (LC-MS)based metabolomic analysis can reliably separate and quantify low levels of multiple small phenolic molecules and their structural isomers

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