- Volume 171, Issue 6, 2025

Despite being one of the most common and debilitating mood disorders, bipolar disorder is often misdiagnosed and undertreated. Its pathogenesis is complex, with significant patient variability and inconsistent treatment effectiveness. The brain-gut-microbiota axis plays a critical role in bipolar disorder by modulating neurotransmitter secretion, gut peptides and systemic inflammation. However, the mechanisms by which psychotropic treatments influence gut microbiota composition and their implications for clinical outcomes remain poorly understood. This systematic review evaluated the impact of psychotropic drugs on gut microbiota and their potential role in bipolar disorder treatment outcomes. A comprehensive search across Ovid MEDLINE, Embase, APA PsycINFO, Scopus and PubMed yielded 314 articles, of which 12 met the inclusion criteria (last search: 13 August 2024). The studies included were those on adults with bipolar disorder type I or II receiving psychopharmacological treatments; those with group comparisons (e.g. healthy controls vs. medicated vs. non-medicated) investigating gut microbiome changes; and no restrictions applied to psychotic features, comorbid anxiety or prior treatment responses. Exclusions involved individual case reports, incomplete conference submissions or early terminated studies lacking efficacy analysis. Cochrane ROBINS-I V2 tool was used to measure the risk of bias, and the GRADE approach was utilized to rate the certainty of evidence in included studies. Two authors independently extracted data into Excel spreadsheets, categorizing demographic and clinical characteristics, describing microbiome analytic methods and summarizing findings on gut microbiome changes post-treatment. Given the high variability in methods and outcome measures across studies, all details were reported without data conversion. Data synthesis reveals that psychotropic treatments, including quetiapine and lithium, influence gut microbiota by increasing the abundance of beneficial bacteria supporting gut health and pathogenic bacteria linked to metabolic dysfunction. Notably, female patients exhibited more significant changes in microbial diversity following psychotropic treatment. Additionally, patients treated with psychotropics showed an increased prevalence of gut bacteria associated with multidrug antibiotic resistance. In bipolar patients treated with quetiapine, responders – those experiencing improved depressive symptom scores – displayed distinct gut microbiome profiles more closely resembling those of healthy individuals compared with non-responders. Responders also exhibited neural connectivity patterns similar to healthy subjects. These findings underscore the complex dual impact of psychotropic medications on gut microbiota, with potential consequences for both gut and mental health. While the enrichment of beneficial bacteria may support gut health, the rise in antibiotic-resistant and metabolically disruptive bacteria is concerning. Study limitations include methodological heterogeneity, inclusions of other psychiatric disorders, a high risk of bias in some studies due to incomplete statistical analyses or insufficient control for confounding factors and potential duplication of study populations arising from overlapping authorship. Further research is essential to elucidate the functional consequences of these microbial shifts and their influence on treatment efficacy. Nevertheless, this review highlights the potential of utilizing gut microbiota profiles to inform personalized treatment strategies, optimize therapeutic outcomes and minimize side effects in bipolar disorder. This study was registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/3GUZR).

In this primer, we will review the key distinctions between acute and chronic infections, between mono- and polymicrobial infections and how these distinctions work together to generate the growing crisis of chronic polymicrobial infections. Chronic (non-resolving) infections place a large and growing burden on human health, globally. Following an introduction to the basic properties of chronic polymicrobial infections, we will use an ecological and evolutionary perspective to help outline a research agenda for this field, flagging both challenges and opportunities for improved infection prevention, diagnosis and treatment.

Culturomics approaches have advanced microbial research by enabling the high-throughput isolation and characterization of a broader range of bacterial taxa, including some previously considered unculturable. Here, we present the testing and optimization of a protocol for isolating and identifying hundreds of cultivable microbes from field-grown plants. This protocol was tested and optimized using the root microbiomes of field-grown corn and pea plants under varying environmental conditions in ND, USA. By employing dilution-to-extinction culturing and a two-step barcoding PCR strategy targeting the V4 region of the 16S rRNA gene, we identified over 200 unique bacterial isolates. The optimized bioinformatic pipeline, built around the DADA2 package, ensured accurate amplicon sequence variant detection and taxonomy assignment. The resulting bacterial isolates span diverse phylogenetic groups, including plant-associated taxa known for promoting plant growth and mitigating stress. Our findings highlight the value of culturomics in generating microbial collections for synthetic community design and advancing plant–microbe interaction research. The protocol’s scalability, cost-effectiveness and robust performance demonstrate its potential for widespread application in agricultural microbiome studies.

Streptococcus mutans is commonly associated with the development of dental caries worldwide. Due to their specificity for S. mutans, phage represents a promising avenue for future targeted therapeutic strategies. In this study, we investigated how phage resistance develops in S. mutans. As a model phage, we used ɸAPCM01, which is known to infect a serotype e strain. We isolated and sequenced the genomes of 15 spontaneous resistant mutants and found that 10 had acquired novel clustered regularly interspaced short palindromic repeats (CRIPSR) spacers targeting the phage, with a total of 18 new spacers identified. Additionally, eight strains contained mutations in rhamnose-glucose polysaccharide biosynthetic genes, three of which also acquired spacers. Only the rgp mutants exhibited defects in phage adsorption, supporting the role of these cell surface glycans as the phage receptor. Mutations in rgpF and the newly identified gene rgpX led to severe cell division defects and impaired biofilm formation, the latter of which was also shared by an rgpD mutant. Thus, rgp mutations confer phage resistance but impose severe fitness costs, limiting pathogenic potential. Surprisingly, we found that ɸAPCM01 was capable of binding to and injecting its genome into UA159, a model serotype c strain. However, UA159 was resistant to infection due to an unknown post-entry defence mechanism. Consequently, ɸAPCM01 has the potential to infect both major serotypes associated with dental caries.

A corrigendum of this article has been published full details can be found at https://doi.org/10.1099/mic.0.001645

Bacteriophages can be important drivers of bacterial densities and, therefore, microbial community composition and function. These ecological interactions are likely to be greatly affected by evolutionary dynamics because bacteria can rapidly evolve resistance to phage, while phage can reciprocally evolve to increase infectivity. Most studies to date have explored eco-evolutionary dynamics using isolated pairs of bacteria–phage, but in nature, multiple bacteria and phages coexist and (co)evolve simultaneously. How coevolution plays out in this context is poorly understood. Here, we examine how three coexisting soil bacteria (Ochrobactrum sp., Pseudomonas sp. and Variovorax sp.) interact and evolve with three species-specific bacteriophages over 8 weeks of experimental evolution, both as host–parasite pairs in isolation and as a mixed community. Across all species, phage resistance evolution was inhibited in polyculture, with the most pronounced effect on Ochrobactrum. Between bacteria–phage pairs, there were also substantial differences in the effect of phage on host densities and evolutionary dynamics, including whether pairs coevolved. Our results also indicate bacteria have a relative advantage over phage, with high rates of phage extinction and/or lower densities in polyculture. These contrasts emphasize the difficulty in generalizing findings from monoculture to polyculture and between model bacteria–phage pairs to wider systems. Future studies should consider how multiple bacteria and phage pairs interact simultaneously to better understand how coevolutionary dynamics happen in natural communities.

The relaxation of DNA supercoiling in Campylobacter jejuni leads to increased protein secretion and a more invasive phenotype, but little is known about the specific mechanisms involved. The aim of this study was to elucidate how these induced bacteria interact with epithelial cells to mediate invasion using different cell models. In HT29 epithelial cell monolayers, pre-treatment of C. jejuni with novobiocin to relax DNA supercoiling significantly increased bacterial association and invasion, forming clusters at cell junctions. This invasive phenotype, which we term C. jejuni supercoiling induced (SI), led to marked disruption of tight junctions (TJs) and adherens junctions, as evidenced by the loss of occludin and β-catenin signal during infection. In a 3D spheroid model, C. jejuni (SI) displayed increased association with and penetration into the centre of spheroids, although significant disruption of their integrity was not observed. Further investigation revealed that cytoskeletal dynamics play a pivotal role in this process; inhibition of microtubule polymerization, but not actin polymerization, rescued the β-catenin disruption induced by C. jejuni (SI), highlighting microtubules as key targets for C. jejuni virulence. This study reveals that SI invasion by C. jejuni is associated with the disruption of TJs, suggesting a paracellular route of invasion.

Kinamycin biosynthesis is a complex process that has been extensively studied over the years, yet specific enzymatic steps continue to be unveiled. A diazo group present in the molecule is responsible for the promising antitumour activity of kinamycins, but its installation in the specific strain Streptomyces ambofaciens has yet to be characterized. In this study, we explore the diazo functionalization of kinamycin in this strain. A FAD-dependent monooxygenase is identified, which is essential for kinamycin biosynthesis. In its absence, stealthin C accumulates instead, likely as a pathway shunt product. Furthermore, as a result of the position of the gene encoding this monooxygenase, named alp2F, we also propose new boundaries of the kinamycin biosynthetic gene cluster, resulting in a large cluster spanning over 72 kb. This work paves the way for the continued understanding of the biosynthetic steps that are characteristic of diazo-containing natural products and provides new biocatalysts for molecular engineering and accelerates bioactive compounds production.