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Kurzbeschreibung/Zielsetzung

With this longitudinal, large-scale metagenomics, multi-assay study (mBiomR) on adult hospitalised Population ,which we will start in the beginning of 2023, we aim to explore the distribution dynamics of Gram-negative pathogens and Enterococcus faecium belonging to the “ESKAPE” group in the gut, their adaptation and the resistance mechanisms, in response to antimicrobial exposure. In addition we aim to examine the gut microbiome recovery after completion of antibiotic treatment. With the findings of our study, we aim to provide information on risk factors for selection of pathogenic Gram-negative bacteria and Enterococcus faecium belonging to the ESKAPE group and their resistance determinants for clinicians and those involved in infection control. In particular we aim to identify antibiotics/antibiotic classes that can select for these bacteria and for resistance evolution/selection in the gut. We are going to examine the effect of the two most frequently used antibiotics in Swiss hospitals. This knowledge can inform antibiotic-prescribing patterns, since administrations of antibiotics can be adapted to those with the lowest selection pressure, where appropriate in the clinical situation. In consequence, antimicrobial stewardship strategies can be based on a broader understanding of the impact of different antimicrobial agents on the human intestinal microbiome. This study, which is supported by the Swiss National Foundation (SNF), will take place at the Cantonal Hospital St. Gallen (KSSG) in tight collaboration with Group von Mering, University of Zurich.