Evidence map›Paper›PMID 36928667›Full record

ArticlePloS one2023

Microbial diversity and antimicrobial resistance in faecal samples from acute medical patients assessed through metagenomic sequencing.

Maho Yokoyama, Leon Peto, Eric P Budgell, Nicola Jones, Elizabeth Sheridan, Jane Liu, A Sarah Walker, Nicole Stoesser, Hyun S Gweon, Martin J Llewelyn

Open access · goldFull text read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 68% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Maho YokoyamaDepartment of Global Health and Infectious Diseases, Brighton and Sussex Medical School, Brighton, United Kingdom.
Leon PetoNuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Eric P BudgellNuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-6148-9378
Nicola JonesDepartment of Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Elizabeth SheridanDepartment of Microbiology, University Hospitals Dorset, Bournemouth, United Kingdom.
Jane LiuDepartment of Microbiology, Royal United Hospitals Bath, Bath, United Kingdom.
A Sarah WalkerNuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Nicole StoesserNuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Hyun S GweonSchool of Biological Sciences, University of Reading, Whiteknights, Reading, United Kingdom.ORCID 0000-0002-6218-6301
Martin J LlewelynDepartment of Global Health and Infectious Diseases, Brighton and Sussex Medical School, Brighton, United Kingdom.
University of Oxford · GBBrighton and Sussex Medical School · GBOxford University Hospitals NHS Trust · GBRoyal United Hospital · GBUK Centre for Ecology & Hydrology · GB

Funding

Department of Health RP-PG-0514-20015
6 · The paper itself

Abstract

Antimicrobial resistance (AMR) is a threat to global public health. However, unsatisfactory approaches to directly measuring the AMR burden carried by individuals has hampered efforts to assess interventions aimed at reducing selection for AMR. Metagenomics can provide accurate detection and quantification of AMR genes within an individual person's faecal flora (their gut "resistome"). Using this approach, we aimed to test the hypothesis that differences in antimicrobial use across different hospitals in the United Kingdom will result in observable differences in the resistome of individual patients. Three National Health Service acute Hospital Trusts with markedly different antibiotic use and Clostridioides difficile infection rates collected faecal samples from anonymous patients which were discarded after C. difficile testing over a period of 9 to 15 months. Metagenomic DNA was extracted from these samples and sequenced using an Illumina NovaSeq 6000 platform. The resulting sequencing reads were analysed for taxonomic composition and for the presence of AMR genes. Among 683 faecal metagenomes we found huge variation between individuals in terms of taxonomic diversity (Shannon Index range 0.10-3.99) and carriage of AMR genes (Median 1.50 genes/cell/sample overall). We found no statistically significant differences in diversity (median Shannon index 2.16 (IQR 1.71-2.56), 2.15 (IQR 1.62-2.50) and 2.26 (IQR 1.55-2.51)) or carriage of AMR genes (median 1.37 genes/cell/sample (IQR 0.70-3.24), 1.70 (IQR 0.70-4.52) and 1.43 (IQR 0.55-3.71)) at the three trusts respectively. This was also the case across the sample collection period within the trusts. While we have not demonstrated differences over place or time using metagenomic sequencing of faecal discards, other sampling frameworks may be more suitable to determine whether organisational level differences in antibiotic use are associated with individual-level differences in burden of AMR carriage.

Indexed as

Anti-Infective AgentsClostridioides difficileAnti-Bacterial AgentsDrug Resistance, BacterialHumansMetagenomeMetagenomicsState MedicineAnti-Bacterial AgentsAnti-Infective Agents

Identifiers

PMID36928667
PMCPMC10019653
OpenAlexW4327550256

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read11
identifiers read6
Read underepoch 390

Registered trials

None linked

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.