摘要
出身背景
短期抗生素暴露与人类肠道微生物群和抗生素耐药性基因（ARGs）的改变有关。虽然抗生素对幽门螺杆菌的成功根除至关重要，但根除幽门螺杆菌后对抗生素耐药性基因的组成和数量的短期和长期影响尚不清楚。这项研究使用粪便样本的全基因组鸟枪宏基因组来表征幽门螺杆菌根除治疗前后的肠道微生物群和ARGs。
后果
招募了44名幽门螺杆菌感染患者，其中21名接受了基于克拉霉素的三联疗法的治疗幼稚患者（CLA组）和23名先前治疗失败的患者，其中10名接受了以左氧氟沙星为基础的三联疗法（LEVO组），13名接受了其他组合疗法（other组）。在基线（当前治疗前）、根除治疗后6周和6个月收集粪便样本。在基线时，三组之间在ARGs和肠道微生物群方面只有轻微差异。根除治疗后，治疗后6周肠道ARGs出现短暂但显著的增加，其中与其他两组相比，LEVO组的ARGs变化最为显著。对于治疗幼稚的患者，ErmF丰度较高的患者容易无法根除CLA，并在治疗后获得更多的ARG。对于肠道微生物群，细菌丰富度在6周时下降，并且在6周三组之间的微生物群群落存在显著差异。
结论
我们的研究结果证明了不同根除疗法诱导的肠道微生物群和ARGs的动态变化，这可能会影响根除疗法中抗生素的选择。
Abstract
Background
Short-term antibiotics exposure is associated with alterations in microbiota and antibiotic resistance genes (ARGs) in the human gut. While antibiotics are critical in the successful eradication of Helicobacter pylori, the short-term and long-term impacts on the composition and quantity of antibiotics resistance genes after H. pylori eradication are unclear. This study used whole-genome shotgun metagenomic of stool samples to characterize the gut microbiota and ARGs, before and after H. pylori eradication therapy.

Results
Forty-four H. pylori-infected patients were recruited, including 21 treatment naïve patients who received clarithromycin-based triple therapy (CLA group) and 23 patients who failed previous therapies, in which 10 received levofloxacin-based quadruple therapy (LEVO group) and 13 received other combinations (OTHER group). Stool samples were collected at baseline (before current treatment), 6 week and 6 month after eradication therapy. At baseline, there was only a slight difference among the three groups on ARGs and gut microbiota. After eradication therapy, there was a transient but significant increase in gut ARGs 6 week post-therapy, among which the LEVO group had the most significant ARGs alteration compared to other two groups. For treatment naïve patients, those with higher ErmF abundance were prone to fail CLA eradication and gain more ARGs after treatment. For gut microbiota, the bacteria richness decreased at 6 week and there was a significant difference in microbiota community among the three groups at 6 week.

Conclusions
Our findings demonstrated the dynamic alterations in gut microbiota and ARGs induced by different eradication therapies, which could influence the choices of antibiotics in eradication therapy.

https://onlinelibrary.wiley.com/doi/abs/10.1111/hel.12871