Short-term and long-term impacts of Helicobacter pylori eradication with reverse hybrid therapy on the gut microbiota.
BACKGROUND AND AIMS
Anti-Helicobacter pylori therapy may lead to the growth of pathogenic or antibiotic-resistant bacteria in the gut. The study aimed to investigate the short-term and long-term impacts of H. pylori eradication with reverse hybrid therapy on the components and macrolide resistance of the gut microbiota.


METHODS
Helicobacter pylori-related gastritis patients were administered a 14-day reverse hybrid therapy. Fecal samples were collected before treatment and at the end of week 2, week 8, and week 48. The V3-V4 region of the bacterial 16S rRNA gene in fecal specimens was amplified by polymerase chain reaction and sequenced on Illumina MiSeq platform. Additionally, amplification of erm(B) gene (encoding erythromycin resistance methylase) was performed.


RESULTS
Reverse hybrid therapy resulted in decreased relative abundances of Firmicutes (from 62.0% to 30.7%; P < 0.001) and Actinobacteria (from 3.4% to 0.6%; 0.032) at the end of therapy. In contrast, the relative abundance of Proteobacteria increased from 10.2% to 49.1% (0.002). These microbiota alterations did not persist but returned to the initial levels at week 8 and week 48. The amount of erm(B) gene in fecal specimens was comparable with the pretreatment level at week 2 but increased at week 8 (0.025) and then returned to the pretreatment level by week 48.


CONCLUSIONS
Helicobacter pylori eradication with reverse hybrid therapy can lead to short-term gut dysbiosis. The amount of erm(B) gene in the stool increased transiently after treatment and returned to the pretreatment level at 1-year post-treatment.
['Hsu|Ping-I|PI|https://orcid.org/0000-0003-3905-4674', 'Pan|Chao-Yu|CY|', 'Kao|John Y|JY|', 'Tsay|Feng-Woei|FW|', 'Peng|Nan-Jing|NJ|', 'Kao|Sung-Shuo|SS|', 'Chen|Yan-Hua|YH|', 'Tsai|Tzung-Jiun|TJ|', 'Wu|Deng-Chyang|DC|', 'Tsai|Kuo-Wang|KW|']
D000900:Anti-Bacterial Agents D017291:Clarithromycin D064806:Dysbiosis D005756:Gastritis D000069196:Gastrointestinal Microbiome D016481:Helicobacter Infections D016480:Helicobacter pylori D006801:Humans D054328:Proton Pump Inhibitors D013997:Time Factors
Helicobacter pylori treatment erm(B) dysbiosis microbiome