Proton pump inhibitors enhance the risk of Carbapenem-resistant Enterobacteriaceae by facilitating the transfer antibiotic resistant genes among bacteria in gut microbiome. undefined

The emergence of carbapenem-resistant Enterobacteriaceae (CRE) in recent decades has been a serious threat to global health. In patients treated with broad-spectrum antibiotics, the colonization of CRE is a serious problem to treat certain diseases. In the hospital, where many patients are treated not only with antibiotics but also with non-antibiotic drugs, the colonization of various antibiotic-resistant bacteria is occurring. So, it is necessary to study the risk factors of antibiotic-resistant bacteria colonized in the intestinal microflora of patients from multiple viewpoints. Here, we studied a total of 98 stool samples of patients including 47 CRE carriers and 51 CRE non-colonized patients. We performed not only a basic analysis of the microbial assemblage but also extended analyses including reconstructing 1,106 MAGs and prediction of horizontal gene transfer events. In the consequences, we notably found that the proton pump inhibitors increase the risk of colonization with multidrug-resistant pathogens by facilitating the transfer of mobile genetic elements.