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. 2020 Apr 20;18(4):e3000465. doi: 10.1371/journal.pbio.3000465

Resident microbial communities inhibit growth and antibiotic-resistance evolution of Escherichia coli in human gut microbiome samples

Michael Baumgartner 1,*, Florian Bayer 2, Katia R Pfrunder-Cardozo 1, Angus Buckling 2, Alex R Hall 1
Editor: Isabel Gordo3
PMCID: PMC7192512  PMID: 32310938

Abstract

Countering the rise of antibiotic-resistant pathogens requires improved understanding of how resistance emerges and spreads in individual species, which are often embedded in complex microbial communities such as the human gut microbiome. Interactions with other microorganisms in such communities might suppress growth and resistance evolution of individual species (e.g., via resource competition) but could also potentially accelerate resistance evolution via horizontal transfer of resistance genes. It remains unclear how these different effects balance out, partly because it is difficult to observe them directly. Here, we used a gut microcosm approach to quantify the effect of three human gut microbiome communities on growth and resistance evolution of a focal strain of Escherichia coli. We found the resident microbial communities not only suppressed growth and colonisation by focal E. coli but also prevented it from evolving antibiotic resistance upon exposure to a beta-lactam antibiotic. With samples from all three human donors, our focal E. coli strain only evolved antibiotic resistance in the absence of the resident microbial community, even though we found resistance genes, including a highly effective resistance plasmid, in resident microbial communities. We identified physical constraints on plasmid transfer that can explain why our focal strain failed to acquire some of these beneficial resistance genes, and we found some chromosomal resistance mutations were only beneficial in the absence of the resident microbiota. This suggests, depending on in situ gene transfer dynamics, interactions with resident microbiota can inhibit antibiotic-resistance evolution of individual species.


A human gut microcosm approach reveals that resident microbiota suppress the growth and evolution of resistance in invading Escherichia coli despite the presence of plasmid-borne resistance genes.

Introduction

The over- and inappropriate use of antibiotics has promoted the evolution of resistance in pathogens, resulting in a crisis for human healthcare [1]. To combat this problem, it is important to understand the underlying mechanisms of how resistance is acquired by bacteria and spreads within bacterial populations and communities [2,3]. A large body of research has used direct observations of resistance evolution in simplified laboratory conditions to understand how antibiotics drive the spread of resistance [4,5]. A key limitation of this approach is that it excludes interactions with other microorganisms, which we can expect to be important for bacteria evolving in natural or clinical settings because they spend most of their time in dense and diverse microbial communities. Interactions in species-rich microbial communities might negatively affect growth of individual species via, for example, competition for resources or niche space [6,7]. This may, in turn, inhibit antibiotic-resistance evolution of individual species, because reduced population growth should reduce the supply of new genetic variation. On the other hand, interspecific interactions also potentially have positive effects on growth and evolution of individual species via, for example, exchange of genetic material [8], cross-feeding, or public goods sharing [911]. Community-level interactions can also alter the strength of selection for resistant variants in the population [12,13]. In support of a key role for interspecific interactions in resistance evolution, observations of bacteria isolated from natural and clinical settings indicate genes involved in antibiotic-resistance evolution are often horizontally transferable [1417]. Despite this, direct observations of how these different types of effects balance out are lacking. Consequently, it remains unclear how interactions with species-rich microbial communities affect growth and antibiotic-resistance evolution of individual species or strains of bacteria.

The impact of interactions with other microorganisms for antibiotic-resistance evolution is likely to be particularly important in the human gastrointestinal tract. This is one of the most densely inhabited environments in the world, colonised by a rich diversity of bacteria, viruses, and eukarya, which are embedded in a network of biotic interactions [18,19]. Interactions among microorganisms in the gut microbiome (which we take here to mean the resident microorganisms, their genes, and the local abiotic environment, following Marchesi and Ravel [20] and Foster and colleagues [19]) play an important role for human health [21]. For example, the microbiome minimises potential niche space for invading species, making it harder for them to establish in the community, thereby contributing to colonisation resistance against pathogens [22,23]. This suggests competitive interactions with other microorganisms are common, which we would expect to inhibit population growth of individual taxa and, in turn, constrain their ability to evolve antibiotic resistance. On the other hand, some interactions in the gut may be mutualistic [10] or modify the effects of antibiotics on individual species [24], potentially resulting in a net positive effect on growth. Moreover, recent metagenomic studies [2527] showed the gut microbiome harbours a variety of mobile genetic elements, often carrying resistance and virulence genes, that are shared by community members. Consistent with this, horizontal transfer of resistance genes within individual hosts is central to resistance evolution in several key pathogens found in the gastrointestinal tract [16,2830]. This suggests interactions with other microorganisms in the gut microbiome can also promote growth and resistance of individual taxa. We aimed to quantify the net effect of interactions with species-rich communities of other microorganisms, in particular those found in the human gastrointestinal tract, for growth and resistance evolution of a given strain that newly arrives in the community.

We approached this question using a human gut microcosm system consisting of anaerobic fermenters filled with human faecal slurry, including the resident microbial community and the beta-lactam antibiotic ampicillin, to which bacteria can evolve resistance by chromosomal mutations [31] or horizontal acquisition of beta-lactamase genes [32]. We used ampicillin because beta-lactam antibiotics are very widely used in human healthcare [33], resistance is a major problem [34], and key mechanisms by which bacteria evolve resistance to ampicillin overlap with resistance mechanisms against other antibiotics [35]. Because the microbiota in faecal samples reflects the diversity of the distant human gastrointestinal tract [36], this approach allowed us to produce microcosms containing species-rich communities sampled from human gut microbiomes. We aimed to determine how interactions with this resident microbial community affected growth and resistance evolution of E. coli. We focused on E. coli because it is a ubiquitous gut commensal [37] and key opportunistic pathogen [38] for which antibiotic resistance is an increasing problem [39]. We inoculated each microcosm with a tagged, focal E. coli strain, before tracking its growth and resistance evolution in the presence and absence of ampicillin. By also including microcosms containing sterilised versions of the same faecal slurry (in which the resident microbial community had been deactivated), we quantified the net effect of interactions with the resident microbial community. This approach allowed us to (1) track growth and resistance evolution of the focal strain in the presence and absence of resident microbial communities sampled from several human donors; (2) isolate plasmid-carrying E. coli strains from the resident microbial community and identify constraints on horizontal transfer of resistance genes; and (3) characterise the resident microbial communities and how they changed over time. Our results show the resident microbial community inhibits both growth and resistance evolution of E. coli, despite the presence of resistance plasmids that can be conjugatively transferred to our focal strain in certain physical conditions.

Results

Resident microbial communities suppressed growth of a focal E. coli strain

We cultivated our focal E. coli strain in anaerobic microcosms in the presence and absence of an antibiotic and three different samples of gastrointestinal microbiomes, each from a different human donor, for 7 d (S1 Fig). On average, antibiotic treatment (ampicillin) decreased focal-strain abundance (effect of antibiotic in a generalised linear mixed model with zero inflation, glmmadmb, χ2 = 33.53, df = 1, P < 0.001; Fig 1). For example, after 24 h, focal-strain abundance was reduced compared with ampicillin-free treatments by 69% (SD = 6.02) in the basal medium treatment, 78%–90% (depending on human donor) in the sterilised slurry treatments, and 84%–99.9% (depending on human donor) in the ‘live’ slurry treatments (Fig 1; S1 Table). Inclusion of the resident microbial community from human faecal samples also reduced focal-strain abundance on average, which we inferred by comparing the community treatments (‘live’ faecal slurries, including the resident microbial community) with the community-free treatments (sterilised versions of the same faecal slurries; effect of community in glmmadmb, χ2 = 6.65, df = 1, P = 0.01; Fig 1).

Fig 1. Resident microbial communities suppressed growth and resistance evolution of focal E. coli.

Fig 1

Each panel shows abundance of the focal E. coli strain (in cfu per ml) over 7 d for either basal medium (top row) or with faecal slurry from one of three human donors, in the absence (left panels) or presence (right panels) of ampicillin, which was applied at the sampling time points after 2 h and thereafter at each daily transfer. Empty symbols show community-free treatments; filled symbols show treatments with the resident microbial community; red symbols show microcosms in which we detected ampicillin-resistant colony isolates of the focal strain. The three lines, each with different symbols, in each treatment show three replicate microcosms. Microcosms in which we detected no focal strain colonies are shown at 100. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. cfu, colony-forming units.

The suppressive effect of resident microbial communities depended on both which human donor sample was used to prepare the microcosms (donor × community interaction in glmmadmb, χ2 = 10.23, df = 2, P = 0.006) and the presence of ampicillin (antibiotic × community interaction in glmmadmb, χ2 = 5.2, df = 1, P = 0.02), being strongest for populations exposed to both resident microbiota and the antibiotic (Fig 1). This resulted in extinction of the focal strain (below our detection limit) in populations exposed to ampicillin and the resident microbial communities from human donors 1 and 3. That is, in these treatments, the focal strain failed to colonise the community. For the resident community from human donor 2, the focal strain was driven to very low abundance in the presence of the community and ampicillin together but did not disappear completely (Fig 1). In the absence of ampicillin, resident communities still suppressed the focal strain on average (effect of community in glmmadmb for ampicillin-free treatments only, χ2 = 10.04, df = 1, P = 0.002). As in the presence of ampicillin, the strength of this effect varied depending on human donor, being strongest for the resident microbial community from human donor 1 (effect of community for this donor in the absence of ampicillin: glmmadmb, χ2 = 11.28, df = 1, P = 0.0002; Fig 1 and S1 Table), resulting in exclusion of the focal strain. The resident community from human donor 3 suppressed average growth of the focal strain by approximately 54% across the entire experiment (effect of community for human donor 3 in the absence of ampicillin: glmmadmb, χ2 = 4.77, df = 1, P = 0.03; Fig 1 and S1 Table). For the resident community from human donor 2, average focal-strain abundance was lower in the presence of the community (mean reduction of 24% compared with community-free microcosms; Fig 1 and S1 Table), although this was not statistically significant (effect of community for human donor 2 in the absence of ampicillin: glmmadmb, χ2 = 0.66, df = 1, P = 0.41). We found no evidence that abiotic factors in the sterile faecal slurry were suppressive for the focal strain: there was no significant variation in average focal-strain abundance among the community-free treatments and the control treatment containing only the basal growth medium that was used to prepare faecal slurries (linear mixed-effects model, glmer: χ2 = 0.41, df = 3, P = 0.94). In summary, the resident microbial communities sampled from three human donors each suppressed growth of a focal E. coli strain in anaerobic fermenters filled with faecal slurry, but to varying degrees, and this effect was amplified by adding ampicillin.

Stable total bacterial abundance but variable community composition over time

We used flow cytometry to estimate total bacterial abundance in microcosms containing resident microbial communities. In antibiotic-free microcosms, total bacterial abundance was approximately stable over time (>109 cells/ml; Fig 2) and was higher on average than in microcosms exposed to ampicillin (effect of antibiotic in a linear mixed-effects model, lmm: χ2 = 10.37, df = 1, P = 0.001). However, the suppressive effect of the antibiotic varied over time (antibiotic × time interaction in lmm: χ2 = 101.81, df = 7, P < 0.001), being strongest at the beginning of the experiment. The effect of the antibiotic also varied across communities from different human donors (antibiotic × donor interaction in lmm: χ2 = 79.30, df = 2, P < 0.001), with those from human donors 1 and 2 showing a stronger recovery after the first application of ampicillin (which resulted in a drop in abundance after 24 h) than the community from human donor 3. These results show our experimental setup sustained high numbers of microorganisms in the community treatments over time in both the presence and absence of ampicillin.

Fig 2. Total bacterial abundance over time in community treatments with and without antibiotics.

Fig 2

Each row of panels shows data from one of the three human donors, and the right/left panels show treatments with/without ampicillin. The three replicate communities in each panel are shown by three different lines, each with a different symbol. Total bacterial abundance was measured by flow cytometry (see Material and methods). Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40].

To investigate the community composition in these microcosms, we used amplicon sequencing of the variable regions 3 and 4 of the 16S rRNA gene. This revealed similar levels of within-sample diversity (Shannon’s alpha diversity; Fig 3A) in microbiome samples from the three human donors at the start of the experiment. Within-sample diversity then decreased slightly over the first 24 h of the experiment and significantly between 24 h and 168 h (effect of time in a linear mixed-effects model including data from 24 h and 168 h, lme: F 1, 14 = 481.43, P < 0.001). This applied across the three human donors (effect of human donor, lme: F 2, 15 = 2.07, P = 0.16), which also showed similar shifts in taxonomic composition over time (Fig 3B). Communities at 0 h were dominated by the families Lachnospiraceae and Ruminococcaceae, plus Prevotellaceae for human donor 3. Over time, these groups became less abundant relative to Enterobacteriaceae and Bacteroidaceae. Analysis of the reads assigned to Enterobacteriaceae indicated E. coli was always the most abundant member of this group (see Material and methods), accounting for approximately 99% of the 16S rRNA amplicon reads assigned to Enterobacteriaceae in all samples (S2 Table), with the remaining approximately 1% comprising other species (e.g., Enterobacter sp., Citrobacter sp., and Klebsiella sp.). Compared with changes over time, ampicillin had a weak effect on within-sample diversity (effect of antibiotic: F1,14 = 11.37, P = 0.006). This interpretation was supported by an alternative analysis (principal coordinate analysis [PCoA]; S2 Fig) based on Bray-Curtis dissimilarities. Thus, despite approximately stable total abundance, we saw changes in community composition over time that were more pronounced than differences among communities from different human donors or antibiotic treatments. Despite these changes in relative abundance of different taxa, the identities of the top 5–6 families were stable over time and across human donors (Fig 3B).

Fig 3. Within-sample diversity and changes in community composition over time.

Fig 3

(A) Diversity is estimated here using Shannon's diversity index for samples from three time points (0 h, 24 h, and 168 h, shown at top) and three human donors (see legend), in the presence and absence of ampicillin (‘Amp’, x-axis). Each box shows data from three replicate microcosms per treatment group and time point (except for at 0 h, which shows the single initial sample from each human donor). (B) Relative abundance of the 15 most prevalent bacterial families in each microcosm at three time points (0 h, 24 h, and 168 h, shown at top) for each human donor (rows of panels, labelled at right) in the presence and absence of ampicillin (three replicates each treatment; x-axis). Superscript ‘a’ in the legend indicates obligately anaerobic families. Data are deposited in the European Nucleotide Archive under the study accession number PRJEB33429.

We used quantitative PCR (qPCR) to better understand the contribution of resident E. coli and the focal strain to the total abundance of E. coli (see S1 Methods). Consistent with the amplicon sequencing data, this revealed increasing total abundance of E. coli sequences over time in both the presence and absence of ampicillin (S3 Fig). The copy number of focal-strain sequences relative to total E. coli indicated the focal strain was rare relative to other E. coli after 24 h (S3 Fig and S2 Table). At the end of the experiment, consistent with our estimates from selective plating and colony PCR, the focal strain was below the detection limit in treatments containing the community from human donor 1, both with and without ampicillin, and the human donor 3 community with ampicillin; in the other treatments, focal-strain sequences were rare compared with total E. coli (S2 Table).

Antibiotic resistance evolved only in the absence of resident microbial communities

We screened for the emergence of antibiotic-resistant variants of the focal strain (that had acquired resistance to ampicillin) after every growth cycle by plating each population onto antibiotic-selective plates (8 μg/ml ampicillin; approximating the minimal inhibitory concentration [MIC] of the focal strain). We never observed resistant variants of the focal strain in any of the community treatments (populations exposed to the resident microbial communities from human microbiome samples). By contrast, in community-free treatments (basal growth medium and sterilised human faecal slurries), resistant variants appeared toward the end of the experiment at 120 h (slurry from human donor 1) and 144 h (basal growth medium and slurry from human donor 3), although not in sterilised samples from human donor 2 (Fig 1). Thus, the resident microbial community from human microbiome samples suppressed antibiotic-resistance evolution in our focal strain.

To investigate genetic mechanisms associated with resistance evolution and general adaptation to our experimental conditions, we performed whole-genome sequencing for two sets of focal-strain isolates from the final time point: eight ampicillin-resistant colony isolates from ampicillin plates (one from each of the eight populations in which we observed the emergence of antibiotic resistance during the experiment) and 33 randomly selected colony isolates from ampicillin-free plates (each from a different population and across all treatments). In the antibiotic-resistant isolates, all SNPs and the deletion we found (Table 1) were in genes related to membranes (ompR, ftsI, opgB), stress responses (relA), or transcription (rpoC, rpoD). Two genes were mutated independently in multiple colony isolates: rpoC and rpoD. We also detected an insertion sequence (IS) movement between perR and insN in two colony isolates. Of genes in which we detected mutations in a single colony isolate, ftsI [41], relA [42], and ompR [43] have each been previously annotated as being involved in resistance to beta-lactam antibiotics. ompR was also mutated in three randomly selected colony isolates, all from populations that had been exposed to ampicillin during the experiment (S3 Table). We found six other genes mutated in parallel in between two and five randomly selected colony isolates (S3 Table). Five of these were mutated in isolates from both antibiotic and antibiotic-free treatments. This included insN and gtrS, both mutated in five isolates. Across the two sets of colony isolates (randomly selected and antibiotic resistant), three other loci were mutated in both sets. These were rpoD (only in isolates that had been exposed to antibiotics), opgB, and yaiO (both in isolates from antibiotic and antibiotic-free treatments). In summary, we found some parallel genetic changes specific to antibiotic treatments and consistent with known resistance mechanisms, plus other genetic changes that occurred across antibiotic and antibiotic-free treatments and are therefore more likely involved in general adaptation.

Table 1. Genes mutated in ampicillin-resistant colony isolates of the focal strain from the end of the experiment.

Data are deposited in the European Nucleotide Archive under the study accession number PRJEB36309.

Treatment group Human donor Replicate afuB afuC cspB <> cspF cyoA fecI ftsI insA <> uspC insB1 insD1 ompR opgB* perR perR <> insN relA rpoC rpoD yaiO* yehE yjhD <> insO yjhD <> yjhE
Basal medium with antibiotic None 1 x x x
2 x x
3 x
Community-free with antibiotic 1 1 x x x
2
3 x x x
Community-free with antibiotic 3 1 x
2 x x

*Genes also mutated in randomly selected clones from ampicillin-free plates (see S3 Table).

▲ Deletion.

x Insertion.

● SNP.

Plasmid acquisition was constrained by lack of transfer, not lack of fitness benefits

We next sought to explain why we never observed antibiotic-resistance evolution of the focal strain in the presence of resident microbial communities, which we had expected to harbour beneficial resistance genes [26,27,4446]. We hypothesised this could have been due to a lack of horizontally transferable resistance genes in the resident microbial communities. However, we detected ampicillin-resistant E. coli in the resident microbial communities from human donors 1 and 3 (by selective plating), and after sequencing their genomes, we identified several antibiotic-resistance genes that were associated with plasmid genes (Fig 4 and S4 Table). In the hybrid assembly (using MinION and Illumina reads) of a representative isolate from human donor 1, we identified two plasmids. The larger plasmid had four known resistance genes (Fig 4A), including one conferring resistance to beta-lactam antibiotics. We also identified three IncF replicons on this plasmid and a complete set of tra genes, which are involved in conjugative plasmid transfer. The second plasmid carried a known replicon (ColRNAI) and mobilisation genes (mbeA and mbeC), plus a complete colicin E1 operon (cnl, imm, cea). For a representative isolate from human donor 3, we found the plasmid replicon and resistance genes integrated on the chromosome (Fig 4B). This putative integrated plasmid from human donor 3 also carried multiple resistance genes, including a beta-lactamase and an IncQ replicon, which is a part of the repA gene [47], but we detected no tra genes. The other five genome assemblies (Illumina reads for other isolates from the same human donor) contained the same resistance genes and replicons across multiple smaller contigs (S4 Table). Mapping the corresponding sequencing reads of all Illumina-sequenced isolates to the long-read data single contig found in the isolates sequenced on the MinION platform revealed identical mapping in all 10 cases, consistent with these genomes having the same structure across each of the isolates (S4 Table).

Fig 4.

Fig 4

Schematic maps of plasmids and chromosomes for representative resident E. coli isolates from (A) human donor 1 and (B) human donor 3. Sequences are annotated with known plasmid replicon sequences (IncFIA, IncFIB, IncFIC on plasmid 1 and ColRNAI on plasmid 2 in [A]; IncQ on the chromosome in [B]), genes involved in horizontal transfer (tra and trb), known resistance genes (blaTEM, sul2, aph(3), aph(6), mdf), genes involved in type VI secretion systems (tss, vgrG), and genes involved in colicin production and immunity (cea, cnl, imm) and mobilisation (mbeA and mbeC). The genome of the isolate from human donor 3 (B) is not closed, as indicated with a gap. Colours indicate coding (black) and noncoding regions (green); note the scale varies among chromosomes and plasmids.

We hypothesised that the lack of plasmid-driven resistance evolution in our focal strain might have been caused by constraints on conjugative transfer that made these plasmids inaccessible. Using a conjugative mating assay on agar, we never found transconjugants of our focal strain when it was mixed with an isolate from human donor 3 (identified above as carrying a putative integrated plasmid). This is consistent with the lack of tra genes on this plasmid and suggests it could not be transferred into our focal strain by conjugation in the absence of other drivers of horizontal gene transfer (e.g., phages or other plasmids). This is also consistent with past work suggesting IncQ plasmids are mobilisable rather than conjugative [48,49] and that we did not detect any other plasmid replicons in the same isolates. However, for the plasmid from human donor 1, we found transconjugants of our focal strain at the end of the mating assay, which we confirmed by colony PCR (S4 Fig). This suggests this plasmid was conjugative and could be transferred to our focal strain, consistent with the presence of tra genes on this plasmid (Fig 4A).

Given that the resistance plasmid from human donor 1 was transferable into our focal strain, why did it not spread in the main experiment above? We hypothesised this could result from plasmid-borne resistance being less beneficial than resistance acquired by chromosomal mutation (as we observed in community-free treatments in the main experiment). We would expect a net benefit of resistance to result in increased population growth at the antibiotic concentration applied during the experiment (7.2 μg/ml). We found acquisition of the plasmid conferred a much larger increase in population growth across all nonzero antibiotic concentrations than that observed for evolved colony isolates that had acquired resistance via chromosomal mutation during the main experiment (Fig 5A and S5 Table). Furthermore, in pairwise competition experiments, the transconjugant carrying this plasmid had a strong competitive advantage relative to the wild type in the presence of the resident microbial community from human donor 1 (S5A Fig). This fitness advantage was increased by adding ampicillin at the concentration we used in the main experiment and even further by adding ampicillin at three times the IC90 (concentration required to reduce growth by 90%) of the ancestral focal strain (community × ampicillin interaction by permutation test; P = 0.029; S5B Fig). This shows it would have been highly beneficial for the focal strain to acquire the plasmid in our experiment, particularly in the presence of ampicillin.

Fig 5. Transfer of a resistance plasmid from the resident microbial community is sensitive to abiotic conditions, and it confers a large increase in resistance.

Fig 5

(A) Antibiotic susceptibility of the ancestral focal strain, the version of the focal strain used to isolate transconjugants (see Material and methods), the focal strain with the plasmid (transconjugant), the resident E. coli isolate used as the plasmid donor, and eight evolved focal-strain colony isolates that we isolated on ampicillin (‘amp’) plates and that had chromosomal mutations (S2 Table). Average OD values ± SE are shown after 24-h growth at each ampicillin concentration. (B) Transconjugant frequency (as a percentage of the total recipient population) after mating experiments in various conditions. The recipient strain was a tagged version of the ancestral focal strain and the plasmid donor was a resident E. coli isolate from human donor 1. For the faecal slurry treatment, we used sterilised faecal slurry from human donor 1. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. LB, lysogeny broth; OD, optical density; rep, replicate population.

Unlike transconjugants carrying the plasmid from resident E. coli, two evolved colony isolates of the focal strain carrying chromosomal resistance mutations had a fitness advantage relative to the wild type only in the absence of the community; in the presence of the resident microbial community, they had a fitness disadvantage (effect of community by permutation test: P < 0.001 for isolates from human donors 1 and 3; S5B Fig). This suggests the genetic changes associated with increased resistance in these isolates in the absence of resident microbiota would not have been beneficial in the Community + Ampicillin treatments of the main experiment, unlike the plasmid we isolated from resident E. coli. This conclusion was supported by comparing transconjugants carrying the resistance plasmid and evolved colony isolates from human donors 1 and 3 (S6 Fig). Further competition experiments showed the competitive advantage of resident E. coli from human donors 1 and 3 carrying resistance genes was also present in the absence of other resident microbiota (S7 Fig).

Another possible explanation for the lack of transfer of the resistance plasmid from human donor 1 in the main experiment is that conjugative transfer might be specific to particular environmental conditions. This has been observed for other plasmids across various experimental conditions [50,51]. We tested this by mating assays as above, but in a range of different experimental conditions. We detected transconjugants that had acquired the plasmid at a final frequency of approximately 0.2% (as a fraction of the total recipient population) after mixing the plasmid-carrying isolate from human donor 1 and the focal strain on an agar surface, but we found no transconjugants after doing the same experiment in three different types of liquid growth medium (lysogeny broth [LB], anaerobic LB, and anaerobic community-free faecal slurry; Fig 5B). This shows transfer of the conjugative plasmid we isolated from human donor 1 requires particular abiotic conditions, which may explain why our focal strain failed to evolve resistance via horizontal gene transfer in the presence of resident microbial communities. This was supported by simulations of a hypothetical plasmid with similar properties but that is transferable in our gut microcosm system (S1 Model). This indicated that, if the plasmid from human donor 1 had been conjugatively transferable in our gut microcosm system, we would have detected transconjugants in our main experiment (although only with relatively high transfer rates; S1 Model). The same model also showed growth suppression of invading lineages by resident microbiota can reduce transconjugant abundance, suggesting even when horizontal acquisition of beneficial resistance genes is common, interactions with resident microbiota can impede their spread.

Discussion

We found resistance via chromosomal mutation to an important class of antibiotics (beta- lactams) evolved in a focal E. coli strain in our experiment only in the absence of resident microbial communities sampled from healthy human volunteers. The suppressive effect of these resident microbial communities was strong enough that the focal E. coli strain was driven towards extinction (below our detection limit) when it was exposed to both ampicillin and the community simultaneously (with communities from two of the three human donors we tested). Consequently, the net effect of the resident microbial communities here was to confer a form of colonisation resistance against a nonresident strain and to prevent that strain from evolving antibiotic resistance. Our analysis of resident E. coli isolates (not the focal strain) from the microbial communities showed this occurred despite the presence of beneficial, potentially horizontally transferable resistance genes. Genomic analyses and conjugation experiments with these resident E. coli isolates showed the in situ transfer dynamics depend critically on genetic (the presence of genes encoding the machinery for conjugative transfer) and abiotic (physical structure of the environment) factors. This is important because ultimately, it is the in situ transfer dynamics that will determine whether or not horizontal transfer of beneficial resistance genes is sufficient to counteract the growth-suppressive effects of interactions with the community and confer a net benefit to invading lineages. Community-level interactions also modified selection for resistance, amplifying growth inhibition by ampicillin and altering the relative advantages/disadvantages of individual resistant genotypes (evolved isolates with chromosomal mutations conferring relatively weak increases in ampicillin resistance had a reduced advantage, but plasmids from resident E. coli that conferred relatively large increases in ampicillin resistance were more beneficial in the presence of resident microbiota). Overall, this indicates resident microbiota influence resistance evolution of invading strains via effects on both population dynamics and the strength of selection for resistance.

The first key implication of our work is that as well as suppressing growth and colonisation by invading strains [23,52], the gastrointestinal microbiota can inhibit antibiotic-resistance evolution. There are several possible ecological mechanisms by which the microbiota may suppress growth of invading lineages [53], such as niche and nutrient competition [54], direct killing via bacteriocins [22,55], phage production [56], or changing the concentration of compounds such as primary and secondary bile acids [57,58]. It was not our aim to pull apart the mechanisms by which resident microbiota suppress invading bacteria (studied in more detail elsewhere; [55,59]). Nevertheless, our data on community structure indicate resident Enterobacteriaceae, including E. coli, had a competitive advantage in our system, potentially explaining suppression of the focal strain. This was further evidenced by the advantage of transconjugants carrying plasmids from resident E. coli (S5 Fig) and resident E. coli over our ancestral focal strain in competition experiments (S7 Fig). The competitive advantage of resident E. coli extended to ampicillin-free conditions in pure culture. Possible contributors to this include type VI secretion systems we detected in the genomes of the human donor 1 and 3 E. coli isolates and a colicin plasmid present in human donor 1 E. coli isolates (Fig 4). In supernatant experiments, we did not find evidence of direct inhibition via phages in the community samples (see S1 Methods). Crucially, no matter how interactions with the microbiota suppress growth of an invading lineage, we expect the reduced population size, growth, and replication to, in turn, reduce the supply of new genetic variation. This is consistent with in vitro work with malaria parasites showing competition between two species under resource limitation impeded drug-resistance evolution [60] and previous studies with Pseudomonas fluorescens showing that a eukaryotic predator [61] or a bacteriophage [62] can suppress the emergence of antibiotic resistance. Thus, suppression of an invading lineage via interactions with resident microbiota may frequently have a knock-on effect on resistance evolution.

A second key implication is that resident microbiota modified selection on antibiotic resistance in our focal strain. The stronger effect of ampicillin on focal-strain growth in the presence of resident microbiota (Fig 1 and S1 Table) indicates resistance would have been more beneficial here. In support, the benefits of resistance plasmid acquisition were greatest in the presence of resident microbiota (S5 Fig). This is counter to the expectation that antibiotics may be less effective in more dense communities because of an 'inoculum effect' [63]. We found inhibition of our focal strain was indeed altered by very high E. coli abundance in pure cultures (S8 Fig), although there was still considerable inhibition even at the highest densities. This indicates such inoculum effects were weaker in the presence of species-rich communities than in pure cultures of E. coli and/or were counterbalanced by opposing effects of community-level interactions on ampicillin inhibition of E. coli. By contrast, chromosomal resistance mutations that emerged in the absence of resident microbiota (and which conferred relatively small increases in resistance in pure culture) were no longer beneficial in the presence of resident microbiota, indicating a larger change in resistance is needed to overcome the relatively strong effect of ampicillin here. This complements recent work showing natural communities from pig faeces can increase costs of antibiotic resistance for individual species [12] and that costs of phage resistance can be altered by interactions with other bacterial species [64]. More generally, this supports the notion that community-level interactions modulate the costs and benefits of antibiotic resistance via mechanisms that are only just beginning to be understood [65].

A third key implication of our data concerns the genetic and environmental constraints on horizontal gene transfer that determine whether or not the growth-suppressive effects of the microbiota are counterbalanced by horizontal transfer of beneficial genes. The unavailability of known resistance genes to the invading focal strain in the community from human donor 3 was because they were integrated in the chromosome. The plasmid we isolated from the human donor 1 community was conjugative, but transfer depended on the abiotic conditions. This suggests the potential for plasmid transfer to allow invading lineages to overcome the suppressive effects of the microbiota depends critically on whether they are conjugative (which can be predicted from sequence data) and on the sensitivity of conjugative transfer to local physical conditions (which is harder to predict from sequence data). Consistent with this, previous research has shown conjugative transfer in E. coli and other species is sensitive to the physical experimental conditions [51,66]. Furthermore, mating pair formation machinery, usually encoded by the plasmid, in some cases promotes biofilm formation, which can, in turn, promote the spread of plasmids [67]. This raises the question of whether some plasmids have evolved to manipulate the physical structure of bacterial populations to promote transfer. Despite these constraints, plasmids are clearly sometimes transferred in vivo, as has been observed in animal models [68,69] and human gut microbiomes [32,44,45]. In line with plasmids being key vectors of beta-lactamases [70], the conjugative plasmid we identified was highly effective in terms of resistance. This suggests plasmid-borne resistance will be under strong positive selection once established and can spread rapidly via clonal expansion. However, our experiment showed the initial horizontal transfer required for such spread is sensitive to genetic and abiotic constraints.

Our approach allowed us to isolate the effect of interactions between diverse microbial communities and a focal E. coli strain. Our amplicon sequence data showed the communities had a representative taxonomic composition for healthy human donors. There were still diverse communities present at the end of the 7-d experiment, albeit with a change in the relative abundance of different taxa. The observed rise of Enterobacteriaceae and Bacteroidaceae has been seen in other experiments with gastrointestinal communities (e.g., [71]) and might be explained by the nutrient content of the medium, micromolar oxygen levels, or such in vitro systems favouring faster population growth [72]. In conditions where antibiotics are applied at higher concentrations or affect a greater fraction of extant taxa, we can expect stronger shifts in community composition in response to antibiotic treatment. We used a sublethal concentration in our main experiment to allow us to track invasion and growth by the focal strain. Nevertheless, in competition experiments at higher antibiotic concentrations, we saw similar outcomes in that plasmids from the resident microbiota were highly beneficial, whereas chromosomal mutations were not (S5 Fig). More importantly, the shift in community composition over the 7-d experiment does not explain the observed suppression of the focal strain, because this was already visible after 1 d.

Although our experimental system likely differs from the gastrointestinal tracts these bacteria were isolated from in ways that affect community composition, cultivating them in vitro allowed us to quantify the effect of species-rich communities sampled from gastrointestinal tracts on resistance evolution of a relevant opportunistic human pathogen. A key limitation of our study is the sample size (three human donors, one focal strain, one antibiotic). Some outcomes might change with different types of resident microbiota or different types of plasmids (explored in the S1 Model). Nevertheless, we observed a qualitatively consistent suppression of the focal strain across the three human donors, which was always stronger in the presence of ampicillin and, in some cases, was associated with colonisation resistance (extinction of the focal strain). Additionally, we chose E. coli and ampicillin because they are both important for understanding resistance evolution in nature and share some important properties in this respect with other bacteria and antibiotics (our rationale is explained further in the Introduction). Despite the low sample size, we observed a qualitatively consistent suppression of the focal strain across the three human donors, which was always stronger in the presence of ampicillin and in some cases was associated with colonisation resistance (extinction of the focal strain). A key challenge for future work will be to uncover the aspects of microbiome composition (e.g., presence/absence of particular taxa) that determine colonisation resistance against invading species and influence antibiotic resistance, whether these are specific to particular invading species/antibiotics, and how such interactions are modified in vivo by local spatial structure [73] and immune responses [74]. Indeed, interactions mediated via the host immune system are another possible mechanism of colonisation resistance [7577].

In conclusion, we showed species-rich microbial communities sampled from human gastrointestinal tracts can suppress growth and resistance evolution of an invading lineage. Given the variety and likely common occurrence of mechanisms that can generate such suppression of invaders (e.g., resource competition), these types of effects are probably common in species-rich communities such as the mammalian gastrointestinal tract. Crucially, resident microbiota also altered the strength of selection for resistance (ampicillin was more suppressive for the focal strain in community treatments) and the fitness effects of individual genetic changes (high-level resistance plasmids became more beneficial in the community treatments, but low-level resistance mutations became less beneficial). Our other data and simulations showed that whether the growth-suppressive effects of resident microbiota are counterbalanced by beneficial horizontal gene transfer depends on genetic and environmental constraints that can impede the spread of resistance plasmids. This has important implications for the prediction of resistance evolution from genetic and metagenomic data, such as those widely collected through surveillance efforts [78,79]: identifying mobile resistance genes in a diverse community is not enough to predict resistance evolution, requiring in addition information about genetic and environmental constraints on in situ transfer dynamics.

Material and methods

Ethics statement

The stool samples used in this study were from anonymous, consenting human donors and the sampling protocol was approved by the ETHZ Ethics Commission (EK 2016-N-55).

Bacterial strains

We used E. coli K12 MG1655 carrying a streptomycin-resistance mutation (rpsL K43R) as the focal strain. Two days prior to the experiment, we streaked the focal strain on LB agar (Sigma-Aldrich, Buchs, Switzerland) and incubated overnight at 37°C. To incubate the focal-strain cultures anaerobically prior to the microcosm experiment, we prepared 42 Hungate tubes (VWR, Schlieren, Switzerland) with LB (Sigma-Aldrich), which was supplemented with 0.5 g/l L-Cysteine and 0.001 g/l Resazurin (reducing agent and anaerobic indicator, respectively), flushed the headspace with nitrogen, sealed the tubes with a rubber stopper, and autoclaved them. One day before the experiment, we randomly picked 42 colonies and inoculated them in the 42 Hungate tubes containing anaerobic LB and incubated at 37°C overnight with 220-rpm shaking. We then used these 42 independent cultures of the focal strain to inoculate the main experiment described below.

Human microbiome samples

All stool samples were collected at the Department of Environmental Systems Science, ETH Zürich, on 15 May 2018. Inclusion criteria were older than 18 y, not obese, not recovering from surgery, and no antibiotics in the last 6 mo. Each sample was collected in a 500-ml plastic specimen container (Sigma-Aldrich) and kept anaerobic using one AnaeroGen anaerobic sachet (Thermo Scientific, Basel, Switzerland). The three samples used for the experiment were randomly selected from a larger number of donated samples. We collected the samples in the morning before the experiment and kept them for maximum 1 h before processing. To prepare faecal slurry from each sample, we resuspended 20 g of sample in 200 ml anaerobic peptone wash (1 g/l peptone, 0.5 g/l L-Cysteine, 0.5 g/l bile salts, and 0.001 g/l Resazurin; Sigma-Aldrich) to prepare a 10% (w/v) faecal slurry. We then stirred the slurry for 15 min on a magnetic stirrer to homogenise, followed by 10 min of resting to sediment. At this point we removed 100 ml of each faecal slurry ('fresh slurry'), which we used later to reintroduce the resident microbial community to sterilised slurry (for the community treatments). To sterilise the faecal slurries, we transferred 100 ml to a 250-ml Schott bottle, flushed the headspace with nitrogen gas, sealed them with rubber stoppers, and autoclaved for 20 min at 121°C.

Inoculating anaerobic gut microcosms, sampling, and bacterial enumeration

For the start of the experiment (S1 Fig), we filled 42 Hungate tubes with 7 ml of basal medium, which was based on earlier studies [80,81] with some modifications (2 g/l Peptone, 2 g/l Tryptone, 2 g/l Yeast extract, 0.1 g/l NaCl, 0.04g K2HPO4, 0.04 g/l KH2PO4, 0.01 g/l MgSO4x7H2O, 0.01 g/l CaCl2x6H2O, 2g/l NaHCO3, 2 ml Tween 80, 0.005 g/l Hemin, 0.5 g/l L-Cysteine, 0.5 g/l bile salts, 2g/l Starch, 1.5 g/l casein, 0.001g/l Resazurin, pH adjusted to 7, addition of 0.001g/l Menadion after autoclaving; Sigma-Aldrich), and for the subsequent re-inoculation cycles with 6.5 ml of basal medium. We flushed the headspace of each tube with nitrogen gas, sealed it with a rubber septum, and autoclaved to produce anaerobic microcosms containing only basal medium.

On day 1 of the experiment, we introduced faecal slurry and antibiotics to each tube according to a fully factorial design (S1 Fig), with three replicate microcosms in each combination of Human Donor (1, 2 or 3), Community (present or absent), and Antibiotic (with or without). In the community-free treatments, we added 850 μl of sterile slurry. In the community treatments, we added 350 μl of fresh slurry and 500 μl of sterilised slurry. In the antibiotic treatment, we added ampicillin to a final concentration of 7.2 μg/ml, approximating the IC90 for the focal strain; this was introduced 2 h after the focal strain had been inoculated (8 μl of focal E. coli from one of the 42 overnight cultures introduced at 0 h; approximately 1:1,000 dilution). As a control treatment testing for the effect of sterilised slurry, we also inoculated the focal strain into three replicate microcosms containing only the basal medium (supplemented with 850 μl of peptone wash to equalise the volume with the slurry treatments), and we did this with and without antibiotic treatment. We incubated all microcosms at 37°C in a static incubator. After 24 h, we transferred a sample of 800 μl from each microcosm to a new microcosm (containing basal medium plus 500 μl of sterile slurry from the corresponding human donor in the community and community-free treatments, or basal medium plus peptone wash for the basal medium treatment, supplemented with ampicillin at each transfer in the antibiotic treatments), and we repeated this for 7 d.

To estimate the abundance of the focal strain during the experiment, we used a combination of selective plating and colony PCR. For selective plating, we serially diluted the samples and plated them on Chromatic MH agar (Liofilchem, Roseto degli Abruzzi, Italy), which allowed us in a first step to discriminate E. coli from other species based on colony colour. By supplementing these agar plates with streptomycin (200 μg/ml), to which our focal strain is resistant, we selected against other E. coli that were not resistant to streptomycin. To screen for variants of our focal strain that acquired resistance to ampicillin during the experiment, we additionally plated each sample onto the same agar supplemented with both streptomycin (200 μg/ml, Sigma-Aldrich) and ampicillin (8 μg/ml, Sigma-Aldrich). We did this after every growth cycle. Despite initial screening of microbiome samples revealing no resident E. coli that could grow on our selective plates, later in the experiment we found such bacteria to be present in some samples (that is, non-focal-strain E. coli that could grow on our plates and were presumably very rare at the beginning of the experiment). To discriminate between these E. coli and our focal strain, we used colony PCR with specific primers (forward [5′-AGA CGA CCA ATA GCC GCT TT-3′]; reverse [5′-TTG ATG TTC CGC TGA CGT CT-3′]). For colony PCR, we picked 10 colonies randomly for each time point and treatment. The PCR reaction mix consisted of 2x GoTaq green master mix, 2.5 μM of each primer, and nuclease free water. The thermal cycle programme ran on a labcycler (Sensoquest, Göttingen, Germany) with 6-min 95°C initial denaturation and the 30 cycles of 95°C for 1 min, 58°C for 30 s, 72°C for 35 s, and a final elongation step of 72°C for 5 min. For gel electrophoresis, we transferred 5 μl of the PCR reaction to a 1.5% agarose gel stained with SYBR Safe (Invitrogen, Thermo F. Scientific) and visualised by UV illumination. Focal-strain abundance was then estimated by multiplying the frequency of the focal strain determined by colony PCR with the total colony count for each plate. To account for the possibility that the focal strain was still abundant in populations in which we found 0/10 colonies (that is, where it could have been rare relative to resident E. coli but still present), we additionally screened the DNA extracted from the community (described in the amplicon sequencing section) of the final time point by PCR (as described before for the colony PCR, but using 30 ng of DNA as template). We did this for all microcosms from the community treatment and detected PCR products in all cases in which we detected focal strain by plating and colony PCR, and none of the cases in which we did not, consistent with our analysis of individual colonies and suggesting that in those microcosms the focal strain had been completely excluded during the experiment.

To estimate total microbial abundance in each microcosm supplemented with the microbiome, we used flow cytometry. We diluted samples by 1:10,000 with phosphate-buffered saline (PBS) and stained them with SYBR Green (Invitrogen, Thermo F. Scientific). We used a Novocyte 2000R (ACEA Biosciences, San Diego, CA, United States of America), equipped with a 488-nm laser and the standard filter setup for the flow cytometric measurements.

We froze samples after every transfer from each microcosm at −80°C, and at the end of the experiment, we isolated two sets of focal-strain colony isolates for sequencing. First, we randomly picked a single focal-strain colony isolate from each microcosm in which the focal strain was detected at the end of the experiment (from streptomycin plates; n = 33). Second, we randomly picked a single ampicillin-resistant colony isolate of the focal strain from each of the eight populations at the end of the experiment in which they were detected (from streptomycin + ampicillin plates; n = 8). We grew each colony isolate overnight in LB (with ampicillin for the ampicillin-resistant isolates), mixed 1:1 with 50% glycerol and stored at −80°C.

Whole-genome sequencing and bioinformatics

We sequenced all of the randomly selected (n = 33) and ampicillin-resistant (n = 8) focal-strain colony isolates (S6 Table). Prior to DNA extraction, we grew each isolate overnight in LB, then concentrated the liquid cultures by centrifugation and extracted DNA with the Magattract kit (Qiagen, Hilden, Germany) according to the manufacturer's protocol. Quality and quantity of DNA was assessed with Nanodrop (Thermo Fisher) and Qubit (Thermo Fisher). At the Functional Genomics Center (ETH Zürich/University of Zürich), DNA was processed with Nextera library prep kit and sequenced on the Illumina Hiseq 4000 platform. We filtered raw sequencing reads with trimmomatic version 0.38 [82] and mapped the reads to the reference with snippy version 0.9.0 (https://github.com/tseemann/snippy) to detect variants. Deletions were identified by using the coverage analysis tool of CLC Genomics Workbench 11 (Qiagen) with a read threshold value of 0 and a window size of 1. We identified IS elements with ISfinder web server (database from July 2018) [83] in the ancestor genome and used these sequences to detect IS movements in the evolved strains with ISMapper version 2.0 [84].

We additionally sequenced 12 ampicillin-resistant resident E. coli colony isolates (not the focal strain, S6 Table). We isolated these colony isolates from microcosms filled with faecal slurry from human donors 1 and 3 at the final time point of the experiment (6 for each donor, each from a different microcosm). We picked, grew, and sequenced these colony isolates as described above for focal strain isolates. We then made de novo assemblies of the resulting sequences with spades version 3.13.0 [85] and annotated them with prokka version 1.13.7 [86]. Additionally, we sequenced one of these resident, resistant E. coli isolates from both human donors (1 and 3) with the Oxford nanopore long-read sequencing platform MinION at University Hospital Basel, Switzerland. These genomes were assembled using Unicycler v0.4.8 with a hybrid assembly approach combining MinION and Illumina reads. Assembly statistics can be found in S7 Table. We screened for known antibiotic-resistance genes and the presence of plasmid replicons by a local blast query against the resfinder (downloaded October 2018) [87] and plasmidfinder (downloaded October 2018) [47], which is a repository of whole-plasmid sequences from members of the Enterobacteriaceae. To identify genes that are involved in mating pair formation or mobilisation of the plasmid, we screened the genome annotation files and blasted potential candidate genes against the NCBI nucleotide database to verify them.

Mating experiments with plasmids from resident E. coli

We aimed to determine whether the resident E. coli colony isolates could act as plasmid donors for our focal strain (transferring antibiotic-resistance plasmids via conjugation). Because the replicate E. coli colony isolates that we sequenced from each human donor (1 and 3) were almost identical on the DNA sequence level (S2 Table), we randomly chose one colony isolate from each human donor as a potential plasmid donor strain. We used a focal strain as the potential plasmid recipient in these experiments, which was only different from the focal strain used in the main experiment by addition of a dTomato marker and a chloramphenicol resistance cassette (enabling us to detect transconjugants by selective plating). In the first set of mating experiments, we grew overnight cultures of the potential plasmid donor strains and the potential plasmid recipient strain in LB at 37°C with shaking. We then pelleted the overnight cultures by centrifugation (3,000 rpm, 5 min), washed them twice with PBS, and resuspended them in 300 μl PBS. We then mixed the donor and recipient strains 1:1 (v:v), transferred 100 μl of this mixture to each of three replicate LB plates, and incubated the plates for 6 h at 37°C. After that, we washed the cells off the plate with 500 μl PBS and streaked out 50 μl of this plate wash on LB plates supplemented with ampicillin and chloramphenicol. To verify plasmid uptake by the transconjugants, we used a colony-PCR screen with primers targeting the recipient strain (same primer set we used above to identify the focal strain) and three additional primer sets targeting the beta-lactamase gene blaTem-1b (blaFW 5′-TGCAACTTTATCCGCCTCCA-3′; blaRV 5′-TTGAGAGTTTTCGCCCCGAA-3′), the traC gene (traFW 5′-TCGATAAACGCCAGCTGGTT-3′; traRV 5′-AGGTGAAAACCCACAGCGAA-3′), and the replicon IncFIC (FII) (IncFW 5′-CACCATCCTGCACTTACAATGC-3′; IncRV 5′-TCAGGCCCGGTTAAAAGACA-3′) with the same PCR reaction mix and settings as described above.

To test whether environmental conditions affected conjugation efficiency, we performed a second set of mating experiments in four different conditions: solid LB agar, liquid LB, liquid anaerobic LB, and anaerobic sterile faecal slurry. We prepared the liquid LB (Sigma-Aldrich) and LB agar (Sigma-Aldrich) for all treatments in the same way (independent of whether they were aerobic or anaerobic), supplementing them with 0.5 g/l L-Cysteine and 0.001 g/l Resazurin. For the anaerobic LB treatment, we transferred 0.9 ml LB to each Hungate tube, flushed the headspace with nitrogen, and sealed it with a rubber stopper before autoclaving. For the anaerobic sterile faecal slurry treatment, we added 0.45 ml LB to each Hungate tube and 0.45 ml thawed slurry under anaerobic conditions, before flushing the headspace with nitrogen, sealing, and autoclaving. Prior to each mating assay, recipient and donor strains were inoculated, washed, concentrated, and mixed exactly the same way as described above for the first set of mating experiments. For each solid and liquid treatment, four replicates were inoculated with 100 μl of the 1:1 donor recipient mix, either under aerobic or anaerobic conditions according to the respective treatment, and all tubes and plates were incubated for 6 h under static conditions at 37°C. We stopped the mating assay by either vortexing the liquid cultures or washing off the cells from the plates with 1 ml of PBS. One hundred microliters of each bacterial suspension was then plated on selective agar plates containing either chloramphenicol to count total number of recipient cells or a mix of chloramphenicol and ampicillin to count the number of transconjugants. After 24 h, we calculated transconjugant frequencies by dividing colony-forming unit (CFU) counts of plasmid-positive colonies by the total CFU count of recipient cells [69].

We measured susceptibility to ampicillin for the ancestral focal strain from the main experiment, the focal strain used in the conjugation experiment (with the dTomato tag), one focal-strain transconjugant (with the plasmid from the resident E. coli isolate of human donor 1), the resident E. coli isolate of human donor 1 (carrying the same plasmid), and all eight ampicillin-resistant focal-strain isolates from the main experiment. We did this by measuring OD600 after 24-h incubation at various concentrations of ampicillin. We prepared overnight cultures of each isolate in a randomly organised master plate and then inoculated the susceptibility assay using a pin replicator to transfer approximately 1 μl of the overnight cultures to assay plates filled with 100 μl of 0–60 μg/ml ampicillin per well. We measured OD at 0 h and after 24 h with a NanoQuant infinite M200Pro plate reader (Tecan).

Amplicon sequencing

We thawed samples of fresh faecal slurry from 0 h and samples from each microcosm in the community treatments after 24 h and 168 h on ice and homogenised them by vortexing. We concentrated each slurry sample by centrifuging 1.5 ml of each sample at 3,000 rpm directly in the bead beating extraction tube, before removing the supernatant and repeating this step, resulting in a total volume of 3 ml of each slurry sample. We then extracted the DNA from this concentrate following the protocol of the powerlyzer powersoil kit (Qiagen). DNA yield and quality were checked by Qubit and Nanodrop.

We amplified the V3 and V4 region of the 16S rRNA gene with three slightly modified universal primers [88] with an increment of a 1-nt frameshift in each primer [89] to increase MiSeq sequencing output performance between target region and Illumina adapter. The target region was amplified by limited 17-cycle PCR with all three primer sets in one reaction for each sample. We cleaned up PCR products, and in a second PCR, adapters with the Illumina barcodes of the Nextera XT index Kit v2 were attached. We checked 10 randomly selected samples on the Tapestation (Agilent, Basel, Switzerland) for the proper fragment size. We quantified library by qPCR with the KAPA library quantification Kit (KAPA Biosystems, Wilmington, MA, USA) on the LightCycler 480 (Roche, Basel, Switzerland). We normalised quantified samples, pooled them in equimolar amounts and loaded the library with 10% PhiX on the Illumina MiSeq platform with the Reagent Kit V3 at the Genetic Diversity Center (ETHZ).

Sequencing reads were trimmed on both ends with seqtk version 1.3 (https://github.com/lh3/seqtk), and amplicons were merged into pairs with flash version 1.2.11 [90]. USEARCH version 11.0.667 [91] was then used to trim primer sites, and amplicons were quality filtered using prinseq version 0.20.4 [92]. We clustered the quality-filtered sequences into zero-radius operational taxonomic units (ZOTUs) using USEARCH. We used Sintax implemented in the USEARCH pipeline with the SILVA database [93] for the taxonomic assignment of the ZOTU sequences. For the analysis of taxonomic data including plotting Shannnon diversity, relative proportions of taxa and to generate the PCoA plots, we used the Phyloseq package in R [94]. To estimate the frequency of E. coli relative to total Enterobacteriaceae, we first isolated all ZOTUs assigned to Enterobacteriaceae and divided these reads into E. coli and other bacteria. We blasted both groups against the SILVA database to check whether the reads were assigned to the right group.

Statistical analyses

We used R 3.5.1 [95] for all analyses. To test whether focal-strain abundance differed between treatments, we used a generalised linear mixed-effects model with the glmmadmb function of the glmmADMB package, with zero inflation and a Poisson error distribution [96]. For this analysis, we excluded the basal medium treatment and used time, antibiotic (with/without), resident microbial community (with/without), and human donor (1/2/3) as fixed effects and replicate population as a random effect. The model was reduced by removing nonsignificant (P > 0.05) interactions using F-tests. P values for interaction terms in the reduced model were obtained with type II Wald chi-squared tests. To test whether there was an inhibitory effect of sterilised slurry on the focal strain, we used the glmer function of the lme4 [97] R package. For this analysis, we included only community-free and antibiotic-free treatments, with focal-strain abundance as the response variable, donor as a fixed effect, replicate population as a random effect, and a Poisson error distribution. After finding interactions between the effects of resident microbiota depending on human donor and antibiotic, we analysed subsets of the dataset to look at ampicillin-free treatments only and individual human donors, using the same approach as for the main model.

To analyse the effects of ampicillin and community presence/absence on the competitive fitness of mutants and transconjugants (see S1 Methods), we used a linear model with the lmp function of the lmperm package [98]. Here we took relative fitness for the respective mutant or transconjugant as the response variable and antibiotic concentration and community presence/absence as fixed effects, testing factor effects by permutation test (accounting for the nonnormal distribution of our fitness data).

To analyse differences in total bacterial abundance in the community treatments, we used a linear mixed-effects model with the lmer function of lme4 [97], with a Poisson error distribution. Time, donor, and antibiotic were fixed effects and replicate population a random effect. To analyse variation of Shannon diversity, we used a linear mixed-effects model with the lme function of nlme [99]. We excluded time point 0 h from the analysis and included time, donor, and antibiotic as fixed effects and replicate population as a random effect. To analyse similarities of microbiome samples based on the 16S rRNA data, we applied the Bray-Curtis distance metric with the ordinate function of the Phyloseq R package to get coordinates for the PCoA. On this dataset, we ran a permutational multivariate analysis of variance (PERMANOVA) with the adonis function of vegan [100], using the distance matrix obtained from the PCoA analysis but omitting time point 0 h. We did this separately for time points 24 h and 168 h.

Supporting information

S1 Fig. Summary of experimental evolution in faecal slurry.

Treatments consisted of basal medium only, basal medium supplemented with sterilised faecal slurry (without the resident microbial community) from one of three human donors, or basal medium supplemented with sterilised faecal slurry to which the resident microbial community had been reintroduced (with community). After inoculation, all treatments were incubated for 2 h at 37°C, before 7 μg/ml ampicillin was added in the antibiotic treatment. Every 24 h, we sampled each microcosm and transferred an aliquot to fresh medium (either basal medium or sterilised faecal slurry) with or without antibiotics. We serially diluted each sample and spread it on chromatic agar plates with or without antibiotics to quantify focal-strain abundance (verified by colony PCR) and to screen for resistance. We sequenced focal-strain isolates from the final time point and investigated community composition by 16S rRNA gene amplicon sequencing. We monitored total bacterial abundance in the community treatments by flow cytometry.

(TIF)

S2 Fig. Variable similarity of microbial communities across time and treatment groups.

Each panel shows samples from a single human donor, with the same axes used in each panel. Points show the initial sample (0 h) and microcosms from 24 h and 168 h with and without antibiotics (legend at right). Similarities between communities were calculated by Bray-Curtis distance and plotted using principal coordinate analysis (see Material and methods). Data are deposited in the European Nucleotide Archive under the study accession number PRJEB33429.

(TIF)

S3 Fig. Abundance of sequences associated with the focal strain, total E. coli, and the resistance plasmid from the microbiota of human donor 1, inferred with qPCR.

Each panel shows the copy number of sequences detected with primers specific for the focal strain, total E. coli, and the resistance plasmid (see legend; further details of primers in S1 Methods) at time point 0 h (left panel), 24 h (middle panel), and 168 h (right panel). Each point shows the mean of three technical replicates. Reactions in which no amplification was detected are shown at 100. We expect plasmid copy number to reflect the abundance of plasmid donor cells, because coverage analysis of whole-genome sequencing data indicated a copy number per cell of approximately 1. For the focal strain and total E. coli, the copy number of sequences does not necessarily reflect the total number of cells of each type, but changes in strain abundance over time would nevertheless be expected to result in strongly correlated changes in sequence copy numbers over time. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. qPCR, quantitative PCR.

(TIF)

S4 Fig. Agarose gel electrophoresis picture of the PCR products specific for plasmid genes and a chromosomal marker of the focal strain.

We used these primer sets to verify plasmid uptake of the transconjugants. Primers are given in the main text in the Material and methods section.

(TIF)

S5 Fig. Competitive fitness of transconjugants and mutants relative to the ancestral focal strain in the presence and absence of resident microbial communities with no ampicillin, sub-MIC ampicillin, and supra-MIC ampicillin.

(A) Final cell densities of competing strains (see legend; Transconjugant is a transconjugant of the focal strain carrying the plasmid from human donor 1, in the left panel; Mutant is an evolved isolate with increased ampicillin resistance from the community-free treatments with slurry from human donor 1, in the middle panel, or human donor 3, in the right panel; Ancestor is the respective ancestral focal strain). Data are shown after 24 h of competition in sterile slurry or community treatments, with and without low or high concentrations of ampicillin (x-axis). (B) Fitness of the transconjugant or mutant relative to the ancestor, calculated as the difference of their Malthusian growth rate in the same experiment. In both panels, the three points show three replicates of the experiment. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. MIC, minimal inhibitory concentration.

(TIF)

S6 Fig

Competitive fitness of transconjugants (carrying the plasmid from resident E. coli of human donor 1) relative to evolved isolates (from community-free treatments with faecal slurry from human donor 1, left, and human donor 3, right). In each panel, relative fitness of the transconjugant strain is shown as the difference in Malthusian growth rates compared with the respective evolved isolate (see S1 Methods). Competitions were done in sterile faecal slurry or the presence of the resident microbial community and with no, low, or high ampicillin concentrations (x-axis). Each point shows a different replicate. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40].

(TIF)

S7 Fig

Abundance of the focal E. coli strain and resident E. coli strains isolated from human donors 1 and 3 (see legend) in monoculture (left) and in coculture (right). Each strain was grown in monoculture in the absence of antibiotics, and each coculture combination was grown in the presence and absence of ampicillin (x-axis). Each point shows a different replicate. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40].

(TIF)

S8 Fig. Effect of starting bacterial density on growth inhibition by ampicillin ('inoculum effect').

Changes in bacterial abundance over 24 h are shown using three different quantification methods (OD, top panel; plating and CFU counting, middle panel; flow cytometry, bottom panel). In each panel, the change in abundance is shown for four starting densities (see legend) and at four antibiotic concentrations. In each panel, the change between 0 h and 24 h is shown (in OD in the top panel, in CFU/ml in the middle panel, and in recorded events/ml in the bottom panel). Each point shows the mean of three replicates; error bars show 1 SD. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. CFU, colony-forming units; OD, optical density.

(TIF)

S1 Table. Abundance of the focal E. coli strain in treatments with and without ampicillin after 24 h and averaged over the entire experiment.

(PDF)

S2 Table. Fraction of focal strain on total E.coli abundance determined by qPCR and a mixed calculation based of colony PCR, flow cytometry, and amplicon data.

qPCR, quantitative PCR.

(PDF)

S3 Table. Genomic variants found in randomly selected colony isolates of the focal strain picked from ampicillin-free agar plates at the end of the experiment.

(PDF)

S4 Table. Antibiotic-resistance genes, plasmid replicons, and genes involved in conjugative transfer and formation of type VI secretion system found on plasmid 1 of isolates from human donor 1 resident E. coli community and on the chromosome of human donor 3 resident E. coli isolates of each replicate population.

(PDF)

S5 Table. IC90 values of ancestor and ampicillin-resistant evolved strains.

IC90, concentration required to reduce growth by 90%.

(PDF)

S6 Table. List of all sequenced isolates.

(PDF)

S7 Table. Assembly statistics for genome sequencing on Illumina and MinION platform of resident E. coli isolated from the resident microbiota of human donors 1 and 3.

(PDF)

S1 Model. Modelling of plasmid transfer and transconjugant growth.

(DOCX)

S1 Methods. Supporting materials and methods.

(DOCX)

Acknowledgments

We thank the Genetic Diversity Center (ETH Zürich), the Functional Genomics Center (ETH Zürich/University of Zürich), Jean-Claude Walser for sequencing and bioinformatics support, Adrian Egli and Helena Seth-Smith from University Hospital Basel for help with MinION sequencing, Jana Huisman for help with simulations, and Vera Beusch for help compiling estimates of plasmid transfer rates from literature.

Abbreviations

IC90

concentration required to reduce growth by 90%

IS

insertion sequence

LB

lysogeny broth

MIC

minimal inhibitory concentration

PCoA

principal coordinate analysis

qPCR

quantitative PCR

Data Availability

Sequences have been deposited in the European Nucleotide Archive under the study accession number PRJEB36309 for the whole-genome sequences of single colonies and PRJEB33429 for the 16S rRNA gene amplicon data. Other data are available through the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq

Funding Statement

Funding was received from the Swiss National Science Foundation project 31003A_165803 (http://www.snf.ch) (to MB and ARH). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Decision Letter 0

Lauren A Richardson

15 Aug 2019

Dear Dr Baumgartner,

Thank you for submitting your manuscript entitled "Resident microbial communities inhibit growth and antibiotic resistance evolution of Escherichia coli in human gut microbiome samples" for consideration as a Research Article by PLOS Biology.

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Decision Letter 1

Lauren A Richardson

18 Sep 2019

Dear Dr Baumgartner,

Thank you very much for submitting your manuscript "Resident microbial communities inhibit growth and antibiotic resistance evolution of Escherichia coli in human gut microbiome samples" for consideration as a Research Article at PLOS Biology. Your manuscript has been evaluated by the PLOS Biology editors, an Academic Editor with relevant expertise, and by independent reviewers.

The reviews of your manuscript are appended below. You will see that the reviewers find the work potentially interesting. However, based on their specific comments and following discussion with the academic editor, I regret that we cannot accept the current version of the manuscript for publication. We remain interested in your study and we would be willing to consider resubmission of a comprehensively revised version that thoroughly addresses all the reviewers' comments. We cannot make any decision about publication until we have seen the revised manuscript and your response to the reviewers' comments. Your revised manuscript would be sent for further evaluation by the reviewers.

Of particular note, the Academic Editor highlights the need to: 1) determine the role of inoculum size and/or antibiotic concentration in the outcome of resistance evolution, 2) contextualize the results of the study with the well-known concept of colonization resistance and better highlight what is known and what is new, 3) provide a better quantification of population abundances, 4) clarify, or at least further discuss, the importance of specific microbiota compositions to the outcome of resistance evolution. Due to the small sample size of fecal microbiota samples used, it is difficult to make strong general conclusions and the limitations must be made clear, as noted by Rev #3. While the Academic Editor appreciates that addressing the point raised by Rev #2 in point #2 (request for assaying temporal stability of bacteria and to explain the differences between donors) would improve the manuscript, we will not require this data in a revision.

We appreciate that these requests represent a great deal of extra work, and we are willing to relax our standard revision time to allow you six months to revise your manuscript. Please email us (plosbiology@plos.org) to discuss this if you have any questions or concerns, or think that you would need longer than this. At this stage, your manuscript remains formally under active consideration at our journal; please notify us by email if you do not wish to submit a revision and instead wish to pursue publication elsewhere, so that we may end consideration of the manuscript at PLOS Biology.

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*****************************************************

Reviews

Reviewer #1:

Baumgartner et al present new findings regarding the evolution and acquisition of antibiotic resistance as it relates to the interplay between a resident microbial community and an invading strain. The authors used an ex vivo fecal slurry culture system that allows a degree of parallelism and replicability that is hard to recapitulate with animal models. They find that the focal strain of E. coli evolves resistance to ampicillin in the absence of a microbial community but not in its presence, and that failure to mobilize plasmids bearing antibiotic resistance from endogenous E. coli strains is likely one underlying cause.

Generally, I am interested by and like the study, and I believe that the development of ex vivo models is important to advance the mechanistic understanding of microbiome biology. The statistical analyses appear sound. However, I find parts of the study unsatisfying.

Major comments:

1. It is not very surprising to me that the evolution of antibiotic resistance depends on selection for mutations arising within a population, and that limitation of population size restricts the availability of mutants for selection to act on. This appears to be what is occurring for Donors 2 and 3 in the presence of antibiotics. The authors state “Given the variety and likely common occurrence of mechanisms that can generate such suppression of invaders (e.g. resource competition), these types of effects are likely common in species-rich communities such as the mammalian gastrointestinal tract.” If the observed phenotype in donors 2 and 3 + amp was due to resource competition, why was it not observed in the no antibiotic condition?

I can see at least two possibilities for what could be occurring for these samples. First, exposure of the focal strain to the community results in sensitization to antibiotics. Second, the focal strain, while normally able to resist inhibition by the community, is destabilized by antibiotics such that colonization resistance by the community is unmasked.

The first possibility could potentially be addressed by taking isolates from each timepoint from these samples and performing assays such as those presented in Fig 5A, the hypothesis being that exposure to the community results in increased sensitization to antibiotics over time. The second point could potentially be addressed by asking if a pulse of antibiotics then removal results in a similar subsequent elimination of the focal strain, or if persistent addition of antibiotics is required.

2. The plasmid from Donor 1 was able to be transferred in vitro on agar but not in liquid culture or in the static incubator. Since conjugation and mobilization of plasmids does indeed occur in vivo (for example, in Stecher et al cited in ref. 55), I am concerned that this lack of mobilization merely reflects the unsuitability of the static incubation culture system for modeling the contact-dependent interactions required for conjugation that occur in the physiological context of the gut. To this point, static incubation in a Hungate tube may not approximate the gut environment, where presumably mixing through effects of peristalsis or motility take place, and some bacteria could inhabit biofilms where horizontal gene transfer is common (De Vos 2015, NPJ Biofilms and Microbiomes; Stalder and Top 2016, NPJ Biofilms and Microbiomes). Another point relevant here is that only in Donor 1 did the focal strain decrease in abundance in the absence of antibiotics suggesting that the endogenous microbiota were particularly “good” at suppressing the growth of the focal strain. Decreased growth corresponds to fewer cells to partake in conjugative transfer (and hence perhaps the failure to recover resistant colonies), yet the data in Fig 5B suggests that the culture conditions are the primary effect.

3. I think it would be very useful to have a more granular understanding of the Enterobacteriaceae expansion at the species level (or even just at the level of total E. coli abundance). The relative abundance taxonomic data show an increase in Enterobacteriaceae in the later timepoint, to between ~25-50%. The authors state that this includes the focal E. coli strain, but at between 0-30% of the total Enterobacteriaceae. What proportion of the Enterobacteriaceae are endogenous E. coli? Is expansion of endogenous E. coli driving the overall increase across donors? This could be accomplished by qPCR analysis, for example.

Minor comments:

1. The amount of detail in the figure legends could be improved. An example is Fig 5A, where the assay itself is not described. Extrapolating from the methods, the authors took 1ul of an overnight culture and diluted it 1:100 in media containing antibiotic. Is the starting OD600 really ~0.75 after a 1:100 dilution from an overnight? A more traditional way to do this experiment would be to back dilute further, allow cultures to grow to a defined OD600 value (say 0.6), before adding antibiotic. This ensures that viable cell counts from exponential phase are more consistent across conditions.

2. The plot in Figure 3 is difficult to look at (axis labels are challenging to read due to density of text). I suggest limiting the text somehow, or moving this to supplemental material.

3. The authors do not cite any of the numerous studies utilizing metagenomics to assess the mobility of antibiotic resistance genes in humans. For instance, Jiang, Alm and colleagues used metagenomic analyses to report that antibiotic resistance often spreads through mobile genetic elements in human gut samples (bioRxiv, 2017 https://doi.org/10.1101/214213).

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Reviewer #2:

The paper by Baumgartner et al. shows how the presence of a resident bacterial community can modulate the suppressive effects of an antibiotic on growth and colonization by an invader, in this case an E. coli focal strain in an experimental in-vitro system. They also compare antibiotic resistance evolution in the focal strain, in the presence and absence of the resident community, and find that in the presence of competition with a resident community, antibiotic resistance evolution was also suppressed. In fact resistance only evolved by chromosomal mutation and in the absence of a resident microbial community. These genetic mutations are described in detail. The lack of resistance evolution by plasmid-transfer in the presence of a resident community could not be explained via lack of available resistance plasmids among such bacteria, and the authors claim in the paper that it may be due to genetic constraints in one case (resident bacteria from Donor 3), and physical constraints in the other (resident bacteria from Donor 1). The paper is well-written and the experiments and statistical analyses reasonably performed, although some of the results in my view are not extremely novel or surprising, and moreover some of the empirical patterns reported are simply reported and not integrated with each other, leaving unclear what is it that one exactly learns from them. My points are listed below:

1. The main results on colonization resistance from resident microbiota are known for a number of years now, and in in-vivo settings, so the first results obtained by the authors are only incremental, testing colonization resistance in a particular case in vitro. I have a remark about the statistical analyses performed to prove this point in the paper, that all the experiments are analyzed simultaneously in the model (page 6). It is only in this way by aggregating antibiotic-free and antibiotic-treatment dynamics that colonization resistance emerges from the results of this paper. In fact, if one looks at figure 1, it is only in 1/3 of "hosts" or cases, that colonization resistance is observed in the 'baseline regime' without antibiotics. I think unifying all experiments loses the patterns in the data: a more accurate representation and modeling of this data, would be separating the antibiotic-free and antibiotic-treatment results. What is interesting, is that even when colonization resistance was not observed in the absence of antibiotics, and instead invasion and coexistence occurred, suppressive effects by residents were observed in the presence of antibiotics. Thus antibiotics modulate the effective competition between resident community and invader in donors 2 and 3, and amplify the competitive exclusion in donor 1. I think the author's general mechanical application of statistical modeling to all data in a single shot misses these intricate patterns.

2. The other results about total bacterial abundance and diversity.

- Did the authors perform any test on the stability of total bacterial abundance in the absence of antibiotics?

- The fact that antibiotic effect was time-dependent is nothing new, it is expected and has been shown from mechanistic models of bacteria-antibiotic interaction and also experimentally (see e.g. the Regoes paper on the pharmacodynamic model 2001) so applying statistical analyses to this phenomenon brings nothing really new, only shows that such an expected pattern applies also here.

- How are the differences between Donors related? So far the paper does not make any attempt to integrate the donor variation across different metrics. Results are presented, differences are shown that exist, but no linkage between them, e.g. via some population dynamic modeling. Or are they unrelated? Just descriptive statistics of the resident community in different cases? Then the question is what did we learn?

- A similar point applies to the changes in diversity over time: time in this dataset emerges to be a stronger predictor of changes in diversity than presence/absence of antibiotics. What is the meaning of this? The authors just report this result, but do not explain or interpret its biological consequence. This finding suggests the selection going on in the absence of antibiotics (to in-vitro experimental conditions) is stronger than the selective pressure exerted by the antibiotics. Does this have to do with the dose used, which was sub-MIC? This could be important given other literature findings that antibiotics reduce drastically microbiota diversity. Links with clinical/epidemiological findings actually are important, and should be made here.

3. The finding about antibiotic resistance evolution.

I think this is the most interesting part of the paper, and it's here that this article's strength lies: in the what/how/ and why of such patterns. Unfortunately however, I found this section somewhat incomplete. I agree that mechanisms should be studied, as the authors do, but what about population dynamics of resistance transfer? Efficient evolution via chromosomal mutation or horizontal gene transfer/plasmids depends on the population abundances and frequencies of the donor/recipient cells and corresponding process rates. The authors do not attempt to do any quantification of population dynamics here, and only focus on the molecular constraint and physical constraint, and show that indeed despite the huge beneficial effect of extant plasmids, the transfer did not happen.

It would have been useful to have conducted the experiment at one sub-MIC dose as the authors have done, and at one supra-MIC dose, to see whether the selection pressure imposed actually changes the rate of plasmid spread. In retrospect, such resistance, even if it provided huge benefits, did not evolve because (perhaps?) it was not needed at such low selection pressure. A mathematical model would help to quantify some of these expectations.

I also find the listing of genetic mutations (in parallel or specific) that occurred in the absence of antibiotics something that did not add much to the main point of this paper, which in my view is about interaction between resident and invader. Now why did no such chromosomal mutations evolve in the mixed cases? Is it because they have a very strong fitness cost in competition? Can this be tested? How? As these results stand now, they do not add much insights to the main point of this paper.

5. Overall I find the paper interesting, showing four very important and unexpected outcomes, that deserve to be more central to the paper:

- no colonization resistance in the absence of antibiotics (figure 1, donors 2,3) suggesting that multiple scenarios are possible depending on donor-invader combinations - but this is not commented upon

- plasmid-mediated resistance is not always going to evolve in the invader, even if it is present in a majority background population

- competition resident community-invader amplifies the suppressive antibiotic effects on an invader.

-competition resident community-invader reduces the evolutionary potential of invader populations.

All the other analyses in my view, are secondary and thus require less focus in the main text.

--------------

Reviewer #3:

Baumgartner et al present an interesting study on how microbial communities may inhibit growth and antibiotic resistance evolution of a focal bacterium, in this case E. coli. This study is important for three main reasons:

(i) It is one of very few studies to provide experimental evidence that presence of the gastrointestinal microbiota changes dynamics of antibiotic resistance evolution, emphasizing the role of community interactions for evolutionary change

(ii) It is the presence of both the microbiota and an antibiotic that enhances E. coli extinction and reduces antibiotic resistance evolution, while E. coli is able to establish itself in the microbiota communities in the absence of antibiotics and to evolve antibiotic resistance in the absence of the microbiota.

(iii) Resistance evolution was not mediated by horizontal gene transfer (HGT), even though resistance-encoding mobile elements were present in the microbiota community, highlighting that HGT may be limited by genetic and environmental constraints and generally represents a rare event.

The methods are well chosen and developed; the results are reliable and have been very well analysed statistically. The study is in principle suitable for publication in Plos Biol. However, several major and minor problems still need to be improved.

Major comments:

1) The study is important because of the novel experimental approach and the insights obtained (see above points (i) and (ii)). Yet, the authors should acknowledge the study’s limitations, as only one focal strain, one antibiotic and three microbiota samples were tested. Thus, broader generalizations should be avoided and the limitations briefly described in the discussion.

2) The above point (ii) should be highlighted more clearly in the discussion. It is mentioned in the discussion (lines 283-285), yet in my opinion its importance does not become sufficiently clear. The authors found that the interaction between microbiota and antibiotics enhances E. coli extinction and minimizes resistance evolution in the surviving bacteria, whereas only one of the two does not. This is important, because it could otherwise be criticized that presence of the microbiota alone drives E. coli to extinction (which is usually not the case) or that E. coli is not able under these experimental conditions to evolve antibiotic resistance (which it can in the absence of the microbiota).

3) The authors should assess to what extent an inoculum effect could have influenced the results. If I understood the methods correctly, then antibiotics and E. coli are used at identical concentrations in the treatment with or without microbiota communities. If correct, then the treatment with microbiota has much higher density of bacterial cells and the effective concentration of the antibiotic per bacterial cell is diluted. In turn, the focal E. coli experienced a lower effective dose of the antibiotic. In contrast, E. coli in the treatment without the microbiota experienced a much higher effective dose of the antibiotic. If correct, then it may not be surprising that E. coli only evolved antibiotic resistance in the treatment with the higher selective pressure. Please note that ampicillin is a beta-lactam antibiotic, for which such inoculum effects have been well characterized. See for example: Udekwu et al. (2009) J. Antimicrob. Chemother. 63, 745–757; or Nicoloff et al. 2019 Nature Microbiol. 4, 504–514. One option is to measure ampicillin ICs or determine ampicillin MIC for E. coli under the different cell densities.

4) Ampicillin was used at IC90, according to the methods (Line 429). Yet, there is no reduction in cell number in the microbiota-free treatments, not even at the beginning, when resistance is unlikely to have evolved de novo and/or have spread through the population. Can the authors explain this? In the worst case, some aspect of the experimental design inhibited activity of the antibiotic.

5) Genome sequencing data: The sequence data is not publicly available. Moreover, some summary statistics should be provided, including number of contigs, contig lengths, etc. Moreover, it is unclear whether duplications have contributed to resistance evolution. The duplication of genomic regions with resistance genes is well known to contribute to fast resistance emergence in E. coli. Therefore, this must be evaluated.

6) Plasmids: Without third-generation sequencing, it is difficult to assess whether the contig of interest on human donor 3 is a putative plasmid or not. It may as well be a plasmid integrated in a genomic island, and which has lost the ability to be self-transferred. Long-read sequencing would also be helpful to fully resolved the putative plasmid from human donor 1. Moreover, it does not become clear how the absence of other plasmids was excluded (see lines 239 following).

Minor comments:

1) Lines 33-35: I found the final conclusions of the abstract difficult to read. I suggest simplifying them to make them more accessible to the average reader.

2) The authors should briefly explain why ampicillin was selected for this study.

3) Line 52: Public goods sharing could be mentioned here.

4) Line 85: ‘chromosomally’ should be changed to ‘through new mutations‘. Please note that the beta-lactamase-encoding gene may be acquired horizontally and then be integrated in the chromosome.

5) Lines 93, 117 and 133: replace ‘antibiotics‘ by ‘ampicillin’ or at least use the term in singular (only one antibiotic was used).

6) Line 97: ‘multiple’ is misleading and should be replaced by ‘three’ or ’several’.

7) Line 151: 16S should be written with a Capital S. This also applies elsewhere in the text or figures.

8) Line 152 and Figure 3: I find Supp. Fig. 2 more informative than current Fig. 3. I would at least add Supp. Fig. 2 as a sub-panel of Fig. 3 to the main text.

9) Lines 216 following: It would help the reader if information on the number of strains sequenced is provided here. Similarly, it would be useful to know how presence of plasmid genes was inferred.

10) Lines 226-228: The fact that the reads map against the single contig does not mean that these isolates share the same exact plasmid, as genomic rearrangements may have occurred. Please rephrase this.

11) Lines 250 following: It would help the reader if more precise information on MICs of the various strains would be provided, e.g. in a table.

12) Lines 287-290: The focal strain may have CRISPR-Cas or other defense mechanisms that prevent the invasion by foreign DNA, which may help to explain the troubles the authors found in transferring the plasmid by conjugation. Since the authors sequenced the strains, these mechanisms should be explored.

13) Line 312-313: The quoted papers are actually not that recent anymore. Therefore, this term should be replaced.

14) Lines 324-326: The authors do not provide any experimental evidence for the conclusion drawn. Therefore, the statement should be changed or the data provided.

15) Lines 455-456: The authors should explain the criteria used to design the primers. A quick blastn search revealed that the sequences have perfect hits with several E. coli sequences deposited in NCBI.

16) Line 462: ‘SYBR Safe’.

17) Lines 507, 512, 518-521, 605/612: Please mention the software/tool versions.

18) Line 500: Were all the of the randomly selected strains susceptible to ampicillin? This should have been tested and the data provided.

19) Line 512: ‘Ismapper’.

20) Line 556: This explanation should be moved to the first time Resazurin is mentioned (line 385).

21) Lines 586-589: Please rephrase this sentence.

22) Lines 588-589: Please provide names of the extraction kits.

23) Figure 1. Please provide information on which initial time points are shown. This cannot be inferred from the graphs.

24) Line 938 and Fig. 4 A and B: TEM in blaTEM should be subscript.

Decision Letter 2

Lauren A Richardson

16 Feb 2020

Dear Dr Baumgartner,

Thank you for submitting your revised Research Article entitled "Resident microbial communities inhibit growth and antibiotic resistance evolution of Escherichia coli in human gut microbiome samples" for publication in PLOS Biology. I have now obtained advice from the original reviewers and have discussed their comments with the Academic Editor.

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REVIEWERS' COMMENTS:

Reviewer #1:

I am satisfied that the authors have sufficiently responded to the previous concerns raised upon review of the first submission of their manuscript. The addition of new experimental and simulation data, as well as the substantial textual revisions, have improved the clarity of the manuscript and strengthened the overall findings.

Two minor concerns:

- lines 309-310, refer to the T6SS as the "Type VI Secretion System". Also, "vgr" should be "vgrG"

- line 432, "type VI secretion system" should be capitalized. Also, the authors have not identified genes encoding effectors of the T6SS, just genes encoding conserved components of the apparatus.

Reviewer #2:

After reading this revision, and having checked the authors' answers to all my previous questions, I must say they have put in a significant effort in addressing all concerns raised in the first review, and this has substantially improved their manuscript. In particular, I appreciate the competition experiments (S5 fig) and the modeling exercise S1 model, which now help to clarify the expectations for resistance evolution in this setting. The reorganization of figures and tables, and addition of new information e.g. Table S1, helps also highlight the main message of this work, which is how the presence of a microbial community microcosm impacts quantitatively the dynamics of colonization and evolution of antibiotic resistance. The authors have also commented and discussed more thoroughly in this revision the limitations of the work, which strengthens the current findings and puts them in a wider perspective.

Regarding the differences between donor samples and the condition of no resident community, I would suggest to add a line in the discussion about the importance of studying qualitative differences in terms of microbiota composition and linking those to patterns of colonization resistance and antibiotic resistance evolution. I understand that this was not possible with the current sample size (only 3 donors). But, more generally speaking, rather than presence/absence of a microbial community, as presently done in this paper, it would be an interesting challenge for the future to uncover the key (ecological) determinants in resident microbial community structure that prevent colonization by (specific) invaders and evolution of antibiotic resistance (to specific antibiotics). The authors refer to the importance of immunity and spatial structure in the discussion, but key drivers in this process are likely to be gradients in ecological structure and diversity properties of the resident microbiota itself, relative to the particular invader-antibiotic combination. And this should be mentioned.

In my view, this study provides an important step towards empirically demonstrating colonization resistance scenarios, and highlights new protective effects of resident microbial communities in terms of preventing antibiotic resistance evolution.

Reviewer #3:

The revised manuscript is significantly improved, especially thanks to the additional data. All of my concerns have been very well addressed. Therefore, I recommend acceptance of the manuscript. As pointed out previously, this study is important because it is one of very few studies to provide experimental evidence that presence of the gastrointestinal microbiota changes dynamics of antibiotic resistance evolution, emphasizing the role of community interactions for evolutionary change. Overall, this is a manuscript very well suited for publication in PLoS Biology.

Decision Letter 3

Di Jiang

2 Apr 2020

Dear Dr Baumgartner,

On behalf of my colleagues and the Academic Editor, Isabel Gordo, I am pleased to inform you that we will be delighted to publish your Research Article in PLOS Biology.

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Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Fig. Summary of experimental evolution in faecal slurry.

    Treatments consisted of basal medium only, basal medium supplemented with sterilised faecal slurry (without the resident microbial community) from one of three human donors, or basal medium supplemented with sterilised faecal slurry to which the resident microbial community had been reintroduced (with community). After inoculation, all treatments were incubated for 2 h at 37°C, before 7 μg/ml ampicillin was added in the antibiotic treatment. Every 24 h, we sampled each microcosm and transferred an aliquot to fresh medium (either basal medium or sterilised faecal slurry) with or without antibiotics. We serially diluted each sample and spread it on chromatic agar plates with or without antibiotics to quantify focal-strain abundance (verified by colony PCR) and to screen for resistance. We sequenced focal-strain isolates from the final time point and investigated community composition by 16S rRNA gene amplicon sequencing. We monitored total bacterial abundance in the community treatments by flow cytometry.

    (TIF)

    S2 Fig. Variable similarity of microbial communities across time and treatment groups.

    Each panel shows samples from a single human donor, with the same axes used in each panel. Points show the initial sample (0 h) and microcosms from 24 h and 168 h with and without antibiotics (legend at right). Similarities between communities were calculated by Bray-Curtis distance and plotted using principal coordinate analysis (see Material and methods). Data are deposited in the European Nucleotide Archive under the study accession number PRJEB33429.

    (TIF)

    S3 Fig. Abundance of sequences associated with the focal strain, total E. coli, and the resistance plasmid from the microbiota of human donor 1, inferred with qPCR.

    Each panel shows the copy number of sequences detected with primers specific for the focal strain, total E. coli, and the resistance plasmid (see legend; further details of primers in S1 Methods) at time point 0 h (left panel), 24 h (middle panel), and 168 h (right panel). Each point shows the mean of three technical replicates. Reactions in which no amplification was detected are shown at 100. We expect plasmid copy number to reflect the abundance of plasmid donor cells, because coverage analysis of whole-genome sequencing data indicated a copy number per cell of approximately 1. For the focal strain and total E. coli, the copy number of sequences does not necessarily reflect the total number of cells of each type, but changes in strain abundance over time would nevertheless be expected to result in strongly correlated changes in sequence copy numbers over time. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. qPCR, quantitative PCR.

    (TIF)

    S4 Fig. Agarose gel electrophoresis picture of the PCR products specific for plasmid genes and a chromosomal marker of the focal strain.

    We used these primer sets to verify plasmid uptake of the transconjugants. Primers are given in the main text in the Material and methods section.

    (TIF)

    S5 Fig. Competitive fitness of transconjugants and mutants relative to the ancestral focal strain in the presence and absence of resident microbial communities with no ampicillin, sub-MIC ampicillin, and supra-MIC ampicillin.

    (A) Final cell densities of competing strains (see legend; Transconjugant is a transconjugant of the focal strain carrying the plasmid from human donor 1, in the left panel; Mutant is an evolved isolate with increased ampicillin resistance from the community-free treatments with slurry from human donor 1, in the middle panel, or human donor 3, in the right panel; Ancestor is the respective ancestral focal strain). Data are shown after 24 h of competition in sterile slurry or community treatments, with and without low or high concentrations of ampicillin (x-axis). (B) Fitness of the transconjugant or mutant relative to the ancestor, calculated as the difference of their Malthusian growth rate in the same experiment. In both panels, the three points show three replicates of the experiment. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. MIC, minimal inhibitory concentration.

    (TIF)

    S6 Fig

    Competitive fitness of transconjugants (carrying the plasmid from resident E. coli of human donor 1) relative to evolved isolates (from community-free treatments with faecal slurry from human donor 1, left, and human donor 3, right). In each panel, relative fitness of the transconjugant strain is shown as the difference in Malthusian growth rates compared with the respective evolved isolate (see S1 Methods). Competitions were done in sterile faecal slurry or the presence of the resident microbial community and with no, low, or high ampicillin concentrations (x-axis). Each point shows a different replicate. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40].

    (TIF)

    S7 Fig

    Abundance of the focal E. coli strain and resident E. coli strains isolated from human donors 1 and 3 (see legend) in monoculture (left) and in coculture (right). Each strain was grown in monoculture in the absence of antibiotics, and each coculture combination was grown in the presence and absence of ampicillin (x-axis). Each point shows a different replicate. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40].

    (TIF)

    S8 Fig. Effect of starting bacterial density on growth inhibition by ampicillin ('inoculum effect').

    Changes in bacterial abundance over 24 h are shown using three different quantification methods (OD, top panel; plating and CFU counting, middle panel; flow cytometry, bottom panel). In each panel, the change in abundance is shown for four starting densities (see legend) and at four antibiotic concentrations. In each panel, the change between 0 h and 24 h is shown (in OD in the top panel, in CFU/ml in the middle panel, and in recorded events/ml in the bottom panel). Each point shows the mean of three replicates; error bars show 1 SD. Data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq [40]. CFU, colony-forming units; OD, optical density.

    (TIF)

    S1 Table. Abundance of the focal E. coli strain in treatments with and without ampicillin after 24 h and averaged over the entire experiment.

    (PDF)

    S2 Table. Fraction of focal strain on total E.coli abundance determined by qPCR and a mixed calculation based of colony PCR, flow cytometry, and amplicon data.

    qPCR, quantitative PCR.

    (PDF)

    S3 Table. Genomic variants found in randomly selected colony isolates of the focal strain picked from ampicillin-free agar plates at the end of the experiment.

    (PDF)

    S4 Table. Antibiotic-resistance genes, plasmid replicons, and genes involved in conjugative transfer and formation of type VI secretion system found on plasmid 1 of isolates from human donor 1 resident E. coli community and on the chromosome of human donor 3 resident E. coli isolates of each replicate population.

    (PDF)

    S5 Table. IC90 values of ancestor and ampicillin-resistant evolved strains.

    IC90, concentration required to reduce growth by 90%.

    (PDF)

    S6 Table. List of all sequenced isolates.

    (PDF)

    S7 Table. Assembly statistics for genome sequencing on Illumina and MinION platform of resident E. coli isolated from the resident microbiota of human donors 1 and 3.

    (PDF)

    S1 Model. Modelling of plasmid transfer and transconjugant growth.

    (DOCX)

    S1 Methods. Supporting materials and methods.

    (DOCX)

    Attachment

    Submitted filename: Response_letter_blactam_gut_microcosm.docx

    Attachment

    Submitted filename: Response_letter_blactam_gut_microcosm.docx

    Data Availability Statement

    Sequences have been deposited in the European Nucleotide Archive under the study accession number PRJEB36309 for the whole-genome sequences of single colonies and PRJEB33429 for the 16S rRNA gene amplicon data. Other data are available through the Dryad repository: https://doi.org/10.5061/dryad.t1g1jwszq


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