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ESBL Displace: A Protocol for an Observational Study to Identify Displacing <i>Escherichia coli</i> Strain Candidates from ESBL-Colonized Travel Returners Using Phenotypic, Genomic Sequencing and Metagenome Analysis
oleh: Michael Schweitzer, Alfredo Mari, Tim Roloff, Esther Künzli, Stefanie Heller, Diana Albertos Torres, Marco Meola, Danica Nogarth, Leanid Laganenka, Lisa Prampolini, Helena M. B. Seth-Smith, Olivia Grüninger, Alexander Gensch, Josiane Reist, Sebastian Bonhoeffer, Wolf-Dietrich Hardt, Adrian Egli
| Format: | Article |
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| Diterbitkan: | MDPI AG 2023-01-01 |
Deskripsi
Introduction: Invading extended-spectrum beta-lactamase-producing <i>Escherichia coli</i> (ESBL-PE), non-ESBL <i>E. coli,</i> and other bacteria form a complex environment in the gut. The duration and dynamics of ESBL-PE colonization varies among individuals. Understanding the factors associated with colonization may lead to decolonization strategies. In this study, we aim to identify (i) single <i>E. coli</i> strains and (ii) microbiome networks that correlate with retention or decline of colonization, and (iii) pan-sensitive <i>E. coli</i> strains that potentially could be used to displace ESBL-PE during colonization. Methods and analysis: We recruit healthy travellers to Southeast Asia for a one-year prospective observational follow-up study. We collect and biobank stool, serum, and peripheral blood mononuclear cells (PBMCs) at predefined timepoints. Additional information is collected with questionnaires. We determine the colonization status with ESBL-PE and non-ESBL <i>E. coli</i> and quantify cell densities in stools and ratios over time. We characterize multiple single bacterial isolates per patient and timepoint using whole genome sequencing (WGS) and 16S/ITS amplicon-based and shotgun metagenomics. We determine phylogenetic relationships between isolates, antimicrobial resistance (AMR; phenotypic and genotypic), and virulence genes. We describe the bacterial and fungal stool microbiome alpha and beta diversity on 16S/ITS metagenomic data. We describe patterns in microbiome dynamics to identify features associated with protection or risk of ESBL-PE colonization. Ethics and dissemination: The study is registered (clinicaltrials.gov; NCT04764500 on 09/02/2019) and approved by the Ethics Committee (EKNZ project ID 2019-00044). We will present anonymized results at conferences and in scientific journals. Bacterial sequencing data will be shared via publicly accessible databases according to FAIR principles.