Fungal Infection Risks: How Antibiotics Affect Gut Microbiota

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Drug overdose deaths in the US topped 100,000 this year for the first time during the Covid-19 pandemic, exacerbated by a flood of fake pills online – Copyright AFP/File Patrick T. FALLON

A new finding from the University of Birmingham (UK) demonstrates how antibiotics can lead to fungal infection due to the disruption of drugs on the gut immune system, altering the microbial balance. The research focuses on the hospital setting, with an emphasis on invasive candidiasis.

When patients are given antibiotics to prevent sepsis and other bacterial infections that spread rapidly in hospitals (such as Clostiroides difficile), the effect of antibiotics does not only affect the target organism, leading to alterations in the normal gut microbiota. Hence, it creates opportunities for fungus to occur.

In other words, a reduction in the number of gut bacteria following antibiotic therapy reduces competition for space and leaves more room for fungi to multiply. The problem for doctors is that the underlying factors causing these infections are not well understood.

It was also of concern that when antibiotics disrupt the immune system, fungal infections become poorly controlled and when such fungal infections develop, gut bacteria, including antibiotic target pathogens, are also less prone to the effects of the antibiotic; therefore, the risk of bacterial infection also increases.

To demonstrate this, the scientists used mice treated with a broad-spectrum antibiotic cocktail. The rodents were then infected with Candida albicans. It was found that if infected mice showed increased mortality, this was caused by infection in the gut rather than the kidneys or other organs.

Following this, the researchers identified the parts of the immune system that were missing in the gut after antibiotic treatment. These components were then added back to the mice using immune-boosting drugs. This approach reduced the severity of the fungal infection.

A follow-up assessment of hospital records suggested that similar co-infections likely occur in humans.

The research adds to our understanding of how antibiotics can have additional effects on our bodies. This further highlights the importance of careful management of available antibiotics.

To counter the risk of fungal infections, researchers believe that using immune-boosting drugs alongside antibiotics may reduce the health risks associated with complex fungal infections.

The results appear in the newspaper Cell host and microbetitled “Long-term exposure to antibiotics promotes mortality after systemic fungal infection by causing lymphocyte dysfunction and systemic leakage of commensal bacteria”.

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