Haematopoietic cell transplantation outcomes are linked to intestinal mycobiota dynamics and an expansion of Candida parapsilosis complex species

TY - JOUR

T1 - Haematopoietic cell transplantation outcomes are linked to intestinal mycobiota dynamics and an expansion of Candida parapsilosis complex species

AU - Rolling, Thierry

AU - Zhai, Bing

AU - Gjonbalaj, Mergim

AU - Tosini, Nicholas

AU - Yasuma-Mitobe, Keiko

AU - Fontana, Emily

AU - Amoretti, Luigi A

AU - Wright, Roberta J

AU - Ponce, Doris M

AU - Perales, Miguel A

AU - Xavier, Joao B

AU - van den Brink, Marcel R M

AU - Markey, Kate A

AU - Peled, Jonathan U

AU - Taur, Ying

AU - Hohl, Tobias M

N1 - © 2021. The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2021/12

Y1 - 2021/12

N2 - 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.

AB - 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.

U2 - 10.1038/s41564-021-00989-7

DO - 10.1038/s41564-021-00989-7

M3 - SCORING: Journal article

C2 - 34764444

VL - 6

SP - 1505

EP - 1515

JO - NAT MICROBIOL

JF - NAT MICROBIOL

SN - 2058-5276

IS - 12

ER -