Figure 9.

The dynamics of colonization with MDR K. pneumoniae. Colonization dynamics with multi-drug-resistant K. pneumoniae are determined by the behavior of microbiota-cluster groups rather than the individual vulnerability of the bacteria. One of the dominant clusters contains bacteria belonging to the Enterobacteriaceae family, whereas the other dominant cluster contains Lachnospiraceae and other short-chain fatty acid-producing bacteria. Bacteria belonging to the same cluster reinforce each other, whereas the contrasting clusters act against each other. The effect of clusters overrides the effect of individual bacteria. The balance between clusters is mostly affected by the use of antibiotics, other drugs, and fecal microbiota transplantation (FMT).