A peptidoglycan storm caused by β-lactam antibiotic's action on host microbiota drives Candida albicans infection

Nat Commun. 2021 May 7;12(1):2560. doi: 10.1038/s41467-021-22845-2.

Abstract

The commensal fungus Candida albicans often causes life-threatening infections in patients who are immunocompromised with high mortality. A prominent but poorly understood risk factor for the C. albicans commensal‒pathogen transition is the use of broad-spectrum antibiotics. Here, we report that β-lactam antibiotics cause bacteria to release significant quantities of peptidoglycan fragments that potently induce the invasive hyphal growth of C. albicans. We identify several active peptidoglycan subunits, including tracheal cytotoxin, a molecule produced by many Gram-negative bacteria, and fragments purified from the cell wall of Gram-positive Staphylococcus aureus. Feeding mice with β-lactam antibiotics causes a peptidoglycan storm that transforms the gut from a niche usually restraining C. albicans in the commensal state to promoting invasive growth, leading to systemic dissemination. Our findings reveal a mechanism underlying a significant risk factor for C. albicans infection, which could inform clinicians regarding future antibiotic selection to minimize this deadly disease incidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / adverse effects
  • Candida albicans / growth & development
  • Candida albicans / pathogenicity*
  • Candidiasis / complications
  • Candidiasis / drug therapy
  • Candidiasis / microbiology*
  • Candidiasis / pathology
  • Cell Wall / chemistry
  • Cell Wall / drug effects
  • Chromatography, Liquid
  • Female
  • Gastrointestinal Microbiome / drug effects*
  • Gram-Negative Bacteria / chemistry
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / metabolism
  • Humans
  • Hyphae / growth & development
  • Hyphae / pathogenicity
  • Mass Spectrometry
  • Mice
  • Mice, Inbred BALB C
  • Peptidoglycan / chemistry
  • Peptidoglycan / toxicity*
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / drug therapy*
  • Staphylococcus aureus / chemistry
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / metabolism
  • beta-Lactams / adverse effects*

Substances

  • Anti-Bacterial Agents
  • Peptidoglycan
  • beta-Lactams