ArticleGastroenterology2021
Impact of Antibiotic Resistance Genes in Gut Microbiome of Patients With Cirrhosis.
Article in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Machine Learning Approaches for Microorganism Identification, Virulence Assessment, and Antimicrobial Susceptibility Evaluation Using DNA Sequencing Methods: A Systematic Review.Molecular biotechnology · 2025Pooled it
- Research reviews and prospects of gut microbiota in liver cirrhosis: a bibliometric analysis (2001-2023).Frontiers in microbiology · 2024Pooled it
- Gut microbial dynamics and antibiotic resistance during rifaximin therapy in severe cirrhosis: a ProPILA-Rifax ancillary study.Frontiers in cellular and infection microbiology · 2026Trial
- Microbial cues and T cell immunity: deciphering their interactions in chronic liver disease.Experimental & molecular medicine · 2026Review
- Article
- Lack of association between rifaximin and drug-resistant infections: a global multicenter inpatient cirrhosis cohort.Clinical and molecular hepatology · 2026Article
- Fecal microbiota transplantation in chronic liver disease: Current and future state of the art.Hepatology communications · 2026Review
- Seasonal diet shifts alter the gut microbiome and resistome of captive geriatric giant pandas (Ailuropoda melanoleuca).BMC microbiology · 2026Article
- Novel Insights on Clinical Outcomes Using Integrated Shotgun Metagenomic Profiling of the Gut Microbiome, Resistome, and Host Immune-Inflammatory Response in Hospitalized Patients with Decompensated Cirrhosis.Pathogens (Basel, Switzerland) · 2026Article
- DYSBIOSIS IN ACUTE-ON-CHRONIC LIVER FAILURE - FROM A PATHOPHYSIOLOGICAL COMPONENT TO A THERAPEUTIC TARGET.Arquivos de gastroenterologia · 2026Review
- Increased risk of antimicrobial resistance in patients with cirrhosis and hepatic encephalopathy using rifaximin.Nature communications · 2025Article
- Rifaximin Does Not Increase the Rate of 30-Day Mortality in Patients With Cirrhosis and Daptomycin in Two National US-Based Cohorts.Gastroenterology · 2025Article
- Selective expansion of gut antibiotic resistome and underlying pathways involved in type 1 diabetes.iMetaOmics · 2025Article
- Article
- Food substances alter gut resistome: Mechanisms, health impacts, and food components.Comprehensive reviews in food science and food safety · 2025Review
- Gut Microbiome-Liver-Brain axis in Alcohol Use Disorder. The role of gut dysbiosis and stress in alcohol-related cognitive impairment progression: possible therapeutic approaches.Neurobiology of stress · 2025Article
- Review
- Effect of folpet on hypoglycaemia, intestinal microbiota, and drug resistance genes in mice.BMC microbiology · 2025Article
- The future of clinical trials of gut microbiome therapeutics in cirrhosis.JHEP reports : innovation in hepatology · 2025Review
- Infections in decompensated cirrhosis: Pathophysiology, management, and research agenda.Hepatology communications · 2024Review
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsCirrhosis is associated with changes in intestinal microbiota that can lead to hepatic encephalopathy (HE) and infections, especially with antibiotic-resistant organisms. However, the impact of gut microbial antibiotic resistance gene (ARG) burden on clinical outcomes is unclear. The aims of the study were to determine the impact of ARGs in cirrhosis-related gut metagenome on outcomes and disease progression, study the effect of rifaximin on ARG burden, and compare ARGs in cirrhosis with chronic kidney disease (CKD) and diabetes.
methodsIn outpatients with cirrhosis who underwent metagenomics, we evaluated change in ARG abundances with progression and their multivariable impact on 90-day hospitalizations and deaths over 1 year. We also studied ARGs pre- and 8 weeks post-rifaximin in patients with compensated cirrhosis in an open-label trial. Finally, ARGs from CKD and diabetes studies were compared with cirrhosis on machine learning.
resultsA total of 163 patients with cirrhosis (43 compensated, 20 ascites-only, 30 HE-only, 70 both) and 40 controls were included. ARG abundances were higher in cirrhosis versus controls and worsened with advancing cirrhosis severity; 44 patients were hospitalized and 14 died. ARG abundances were associated with hospitalizations and mortality while controlling for cirrhosis complications, medications, and demographics. Rifaximin trial: ARG abundance patterns were minimally affected in 19 patients post-rifaximin. CKD/diabetes comparison: ARG abundance patterns in cirrhosis are distinguishable on machine learning and include more gram-positive ARGs.
conclusionsCirrhosis is associated with high gut microbial ARG gene burden compared with controls, which worsens with disease progression and may be different from CKD and diabetes. ARGs are not affected by rifaximin and are associated with hospitalizations and death.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.