ArticleFrontiers in microbiology2026
Gut phages are linked to off-target antimicrobial resistance genes in orthopedic patients receiving peri-surgical antibiotics.
Article in Frontiers in microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Antibiotic prophylaxis alters the gut microbiome, potentially expanding antimicrobial resistance genes (ARGs). The role of bacteriophages in this process remains poorly understood. This study investigates the effects of predominantly flucloxacillin- and gentamicin-based perioperative antibiotic prophylaxis on phage and ARG dynamics in orthopedic trauma patients. Methods: Shotgun metagenomic analysis in two orthopedic cohorts: rib fracture fixation ( Results: Following antibiotics, seven VSGs were increased in rib and five in the frail hip fractures compared to controls (mean Log₂ Fold change: 16.89 and 17.21, respectively). In the frail cohort, 18 ARGs increased, including 14 off-target ARGs (resistance genes for antibiotics not administered; mean Log₂ Fold change >25 compared to controls). Five VSGs correlated with six off-target ARGs in antibiotic-treated patients (Rho = 0.612). Longitudinal analysis of rib fracture patients ( Discussion: Our findings suggest perioperative antibiotics may contribute to phage-associated dissemination of off-target ARGs. Understanding how ARGs spread in the gut microbiome is important for improving antibiotic stewardship and protecting vulnerable patients from difficult to treat infections.
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