Not Just Antibiotics: Is Cancer Chemotherapy Driving Antimicrobial Resistance?

Lito E. Papanicolas, David L. Gordon, Steven Wesselingh, Geraint Rogers

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

The global spread of antibiotic-resistant pathogens threatens to increase the mortality of cancer patients significantly. We propose that chemotherapy contributes to the emergence of antibiotic-resistant bacteria within the gut and, in combination with antibiotics, drives pathogen overgrowth and translocation into the bloodstream. In our model, these processes are mediated by the effects of chemotherapy on bacterial mutagenesis and horizontal gene transfer, the disruption of commensal gut microbiology, and alterations to host physiology. Clinically, this model manifests as a cycle of recurrent sepsis, with each episode involving ever more resistant organisms and requiring increasingly broad-spectrum antimicrobial therapy. Therapies that restore the gut microbiota following chemotherapy or antibiotics could provide a means to break this cycle of infection and treatment failure.

LanguageEnglish
Pages393-400
Number of pages8
JournalTrends in Microbiology
Volume26
Issue number5
DOIs
Publication statusAccepted/In press - Nov 2017

Keywords

  • intestinal dysbiosis
  • multiresistant organisms
  • mutation
  • sepsis

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

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abstract = "The global spread of antibiotic-resistant pathogens threatens to increase the mortality of cancer patients significantly. We propose that chemotherapy contributes to the emergence of antibiotic-resistant bacteria within the gut and, in combination with antibiotics, drives pathogen overgrowth and translocation into the bloodstream. In our model, these processes are mediated by the effects of chemotherapy on bacterial mutagenesis and horizontal gene transfer, the disruption of commensal gut microbiology, and alterations to host physiology. Clinically, this model manifests as a cycle of recurrent sepsis, with each episode involving ever more resistant organisms and requiring increasingly broad-spectrum antimicrobial therapy. Therapies that restore the gut microbiota following chemotherapy or antibiotics could provide a means to break this cycle of infection and treatment failure.",
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Not Just Antibiotics : Is Cancer Chemotherapy Driving Antimicrobial Resistance? / Papanicolas, Lito E.; Gordon, David L.; Wesselingh, Steven; Rogers, Geraint.

In: Trends in Microbiology, Vol. 26, No. 5, 11.2017, p. 393-400.

Research output: Contribution to journalReview article

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