Avaliação comparativa do resistoma clínico fecal em individuos eutróficos, com sobrepeso e obesos

Abstract

Obesity is a disease of great impact to public health and is related to changes in physiology, reflected in the gut, especially from an ecological point of view. Under these conditions, changes in microbial community structure may occur, but little is known about its implications in the antimicrobial resistance phenomenon, which currently ranks as a major threat to modern medicine. It is accepted that the intestinal microbiota acts as resistance genes reservoir. Moreover, exposure to different xenobiotics can change the composition of the microbiota and act as an agent of selective pressure in the intestine selecting resistant bacteria. Considering the changes in lifestyle, diet and microbiota that happen in overweight patients, the objective of this research was to evaluate the occurrence of genetic markers representative of the clinical resistoma in the gut metagenome of normal weight, overweight and obese individuals, with no history of recent antibiotic therapy. 72 patients were evaluated and classified as normal weight, overweight and obese according to BMI. Also, anthropometric, sociodemographic and nutrition evaluation of patients was performed. Conventional polymerase chain reaction (PCR) from the fecal metagenomic DNA extracted was used to assess the presence of 59 resistance genes belonging to different families of antibiotics. The density of different bacterial groups was assessed by fluorescence in situ hybridization (FISH). Of the total surveyed genes were detected 27 types of genes, of which 17 resistance genes are shared among the three groups (normal weight, overweight and obese), which indicates the presence of a common core in resistoma mainly made up of genes that confere resistance to tetracyclines and beta-lactams. Moreover, the obese group presents the highest amount of detected genes and variety of genes (176:26), compared to the overweight (145:21) and eutrophic group (132:0). The bacterial density analysis showed mainly the presence of Gram negative anaerobes, followed by Gram negative rods and Gram positive cocci, which were increased in the obese group, particularly Escherichia coli and Acinetobacter baumannii. Also, was calculated the ratio of resistance genes in comparison with the bacterial species showing more likely the emergence of resistance genes for the group of Gram negative rods. We performed the correlation analysis (odds ratio) between resistance genes BMI, caloric intake, consumption of xenobiotics, and use of sweeteners, and a positive correlation between the emergence of resistance genes and these factors was observed. The results suggest that factors related to overweight as BMI, diet and exposure to different xenobiotics affect the composition of the intestinal tract, allowing for a greater likelihood of genetic markers of antimicrobial drug resistance in fecal metagenome.