Fungal Dysbiosis in Cirrhosis is Associated with Culture-negative Infections and Antibiotic Use. feces metagenome

Cirrhotic patients have a high likelihood of developing infections because of altered immune response, multiple hospitalizations and instrumentations and the overuse of antibiotics for treatment and prophylaxis of infections2. While most infections are presumed to be bacterial, recent studies have noted a significant increase in documented fungal infections or infections in which there is no growth i.e. culture-negative infections5. We demonstrate that cirrhotic patients who are hospitalized for culture-negative infections or those who are started on broad-spectrum antibiotics as an outpatient have significant fungal dysbiosis due to Candida overabundance and reduction in fungal diversity that parallels changes in bacterial diversity.