{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:15:41Z","timestamp":1789017341175,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Gut microbiota, including bacteria and phages, are altered in cirrhosis, but their role during infections and spontaneous bacterial peritonitis (SBP) prophylaxis is unclear. Our aim was determine metagenomic changes in gut bacteria; phages and their linkages centered around Gram\u2010negative and Gram\u2010positive pathobionts in patients with cirrhosis with\/without infections or SBP prophylaxis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We included uninfected (<jats:italic toggle=\"yes\">n<\/jats:italic> =\u2009231) and infected (<jats:italic toggle=\"yes\">n<\/jats:italic> =\u200930, SBP <jats:italic toggle=\"yes\">n<\/jats:italic> =\u200919 and urinary tract infection <jats:italic toggle=\"yes\">n<\/jats:italic> =\u200911 before antibiotics) patients who gave stool for bacterial and phage metagenomics. We matched uninfected to infected patients 1:1 on a model for end\u2010stage liver disease (MELD). We also analyzed subgroups of patients with ascites matched on an MELD (<jats:italic toggle=\"yes\">n<\/jats:italic> =\u200973) to patients on SBP prophylaxis (<jats:italic toggle=\"yes\">n<\/jats:italic> =\u20097) and then to SBP infection. Phage and bacterial taxa differences (DESeq2) and correlation networks centered around <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic> and <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic> were analyzed. Infections were mostly due to Enterobacteriaceae and <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic> spp. On metagenomics, higher fold changes of Enterobacteriaceae members, <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic> and <jats:italic toggle=\"yes\">Streptococcus<\/jats:italic> spp., and <jats:italic toggle=\"yes\">Escherichia<\/jats:italic> phages were seen in infected patients. Correlation networks showed more complex bacteria\u2010phage linkages in infected patients compared with uninfected ones overall and centered around <jats:italic toggle=\"yes\">E. coli<\/jats:italic> and <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>. SBP prophylaxis induced higher Gram\u2010positive bacteria. In SBP, <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic> and <jats:italic toggle=\"yes\">Escherichia<\/jats:italic> were higher versus ascites. Correlation networks around <jats:italic toggle=\"yes\">E. coli<\/jats:italic> were complex in ascites but sparse with SBP prophylaxis, whereas the reverse was seen with <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>. Lytic phages and those associated with antibiotic resistance were correlated with <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In cirrhosis, there are significant changes in phage\u2010bacterial linkages in infected patients and those on SBP prophylaxis compared to the remaining patients. SBP prophylaxis enriches complexity of <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>\u2013centered but induces a collapse in <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\u2013centered phage\u2010bacterial correlations.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32571","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T14:20:55Z","timestamp":1652451655000},"page":"1723-1734","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Impact of bacterial infections and spontaneous bacterial peritonitis prophylaxis on phage\u2010bacterial dynamics in cirrhosis"],"prefix":"10.1097","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4928-3681","authenticated-orcid":false,"given":"Jasmohan S.","family":"Bajaj","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical Center,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Pe\u0148a","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"University of Guadalajara,Guadalajara,Jalisco,Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Fagan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical Center,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"McGeorge","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical Center,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Sterling","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical Center,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0764-9737","authenticated-orcid":false,"given":"Hannah","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical Center,Virginia,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Velimir","family":"Luketic","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University and Central Virginia Veterans Healthcare System Medical 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