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Review
. 2016 Apr 18;8(1):40.
doi: 10.1186/s13073-016-0306-z.

Microbiome mediation of infections in the cancer setting

Ying Taur  1 , Eric G Pamer  2
Affiliations
Review

Microbiome mediation of infections in the cancer setting

Ying Taur et al. Genome Med. .

Abstract

Infections encountered in the cancer setting may arise from intensive cancer treatments or may result from the cancer itself, leading to risk of infections through immune compromise, disruption of anatomic barriers, and exposure to nosocomial (hospital-acquired) pathogens. Consequently, cancer-related infections are unique and epidemiologically distinct from those in other patient populations and may be particularly challenging for clinicians to treat. There is increasing evidence that the microbiome is a crucial factor in the cancer patient's risk for infectious complications. Frequently encountered pathogens with observed ties to the microbiome include vancomycin-resistant Enterococcus, Enterobacteriaceae, and Clostridium difficile; these organisms can exist in the human body without disease under normal circumstances, but all can arise as infections when the microbiome is disrupted. In the cancer patient, such disruptions may result from interventions such as chemotherapy, broad-spectrum antibiotics, or anatomic alteration through surgery. In this review, we discuss evidence of the significant role of the microbiome in cancer-related infections; how a better understanding of the role of the microbiome can facilitate our understanding of these complications; and how this knowledge might be exploited to improve outcomes in cancer patients and reduce risk of infection.

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Figures

Fig. 1
Fig. 1
Disruption of the intestinal microbiota during cancer chemotherapy. Under normal circumstances (left), the healthy and diverse bacterial microflora and the host tissues promote stability and colonization resistance, preventing expansion of potential pathogens. Systemic chemotherapy (right) leads to mucosal barrier injury (mucositis). During this time, the microbiota is also disrupted, possibly by chemotherapy or by antibiotics that are given simultaneously, or because of decreased host control over microbial populations, or expansion of a pathogenic species due to mucosal inflammation. The microbiota is dominated by a single pathobiont, which can escape into the systemic circulation by translocation through damaged epithelial tissues. Spread beyond mesenteric lymph nodes particularly occurs as a result of failure of systemic immune defenses
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