Haematopoietic cell transplantation outcomes are linked to intestinal mycobiota dynamics and an expansion of Candida parapsilosis complex species Journal Article
| Authors: | Rolling, T.; Zhai, B.; Gjonbalaj, M.; Tosini, N.; Yasuma-Mitobe, K.; Fontana, E.; Amoretti, L. A.; Wright, R. J.; Ponce, D. M.; Perales, M. A.; Xavier, J. B.; van den Brink, M. R. M.; Markey, K. A.; Peled, J. U.; Taur, Y.; Hohl, T. M. |
| Article Title: | Haematopoietic cell transplantation outcomes are linked to intestinal mycobiota dynamics and an expansion of Candida parapsilosis complex species |
| Abstract: | Allogeneic haematopoietic cell transplantation (allo-HCT) induces profound shifts in the intestinal bacterial microbiota. The dynamics of intestinal fungi and their impact on clinical outcomes during allo-HCT are not fully understood. Here we combined parallel high-throughput fungal ITS1 amplicon sequencing, bacterial 16S amplicon sequencing and fungal cultures of 1,279 faecal samples from a cohort of 156 patients undergoing allo-HCT to reveal potential trans-kingdom dynamics and their association with patient outcomes. We saw that the overall density and the biodiversity of intestinal fungi were stable during allo-HCT but the species composition changed drastically from day to day. We identified a subset of patients with fungal dysbiosis defined by culture positivity (n = 53) and stable expansion of Candida parapsilosis complex species (n = 19). They presented with distinct trans-kingdom microbiota profiles, characterized by a decreased intestinal bacterial biomass. These patients had worse overall survival and higher transplant-related mortality independent of candidaemia. This expands our understanding of the clinical significance of the mycobiota and suggests that targeting fungal dysbiosis may help to improve long-term patient survival. © 2021, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | adult; antibiotic agent; major clinical study; overall survival; mortality; cohort analysis; relapse; acute leukemia; saccharomyces cerevisiae; amplicon; allogeneic hematopoietic stem cell transplantation; intestine flora; mycosis; candida albicans; micafungin; candidemia; fungus culture; microbial diversity; biomass; long term survival; high throughput sequencing; candida glabrata; candida parapsilosis; prognosis; human; article; transplant related mortality; dysbiosis; mortality risk; species composition; candida metapsilosis; candida orthopsilosis; mycobiome |
| Journal Title: | Nature Microbiology |
| Volume: | 6 |
| Issue: | 12 |
| ISSN: | 2058-5276 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2021-12-01 |
| Start Page: | 1505 |
| End Page: | 1515 |
| Language: | English |
| DOI: | 10.1038/s41564-021-00989-7 |
| PROVIDER: | scopus |
| PUBMED: | 34764444 |
| PMCID: | PMC8939874 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 January 2022 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work