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This chapter is from the book

This chapter is from the book

Antibiotic Resistance: Understanding and Responding to an Emerging CrisisAntibiotic Resistance: Understanding and Responding to an Emerging Crisis

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This chapter is from the book

This chapter is from the book

Antibiotic Resistance: Understanding and Responding to an Emerging CrisisAntibiotic Resistance: Understanding and Responding to an Emerging Crisis

Learn More Buy

Broad-Spectrum Antibiotics Also Perturb Our Microbiomes

Our bodies contain trillions of bacteria that have evolved to live in humans. More than 38,000 different species live in the human digestive tract, and bacteria occupy at least 20 distinct niches on our skin. The microbes carried by each host are collectively called a microbiome. Humans have evolved to take advantage of the bacteria, and the bacteria gain advantage from us. Box 1-2 describes examples relating to obesity and pain. Some bacteria help humans digest food, whereas others protect from particular pathogens. For example, acid-producing bacteria in the vagina keep yeast populations in check. The complex ecosystem of the digestive tract protects humans from Clostridium difficile, the cause of a serious form of diarrhea and bowel inflammation. An unwelcome consequence of antibiotic treatment is the death of much of our microbiome, which can enable resistant pathogen populations to expand.

Box 1-2: Microbiomes Contribute to Obesity and Pain

Although human digestive tracts contain many different types of bacteria, more than 90% of the total is composed of two general types: the Bacteroidetes and the Fermicutes. These bacteria, along with others, extract energy from foods that would otherwise be indigestible. Obese persons have a higher percentage of Fermicutes in their guts than thin persons, and when obese persons lose weight, the percentage of Bacteroidetes increases. The increased fraction of Bacteriodetes appears to be associated with lower harvest of energy from food.11 A similar difference is observed with genetically obese mice. The obese mice appear to be better able to extract energy from their food, leaving considerably less energy in their feces. When normal, germ-free mice received gut bacteria from obese mice, they put on substantially more body fat than when given bacteria from normal mice, even though food consumption was the same in the two groups. Could gut bacteria contribute to human obesity? Could a shift in microbiome explain why farmers get better growth from cattle fed low levels of antibiotics as "growth promoters"?

Microbiomes may also contribute to sensing some types of pain, as studies with mice indicate. One form derives from inflammation, a complex immune response involving the balance of small molecules called cytokines. Germ-free mice are deficient in the ability to experience a type of inflammatory pain. Introducing bacteria from normal mice into the guts of germ-free animals brought the sensation of pain to normal levels after 3 weeks.12 Thus, gut bacteria do more than just help mammals digest food.

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Last Update: November 17, 2020