Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humans Journal Article

   

Authors:	Ubeda, C.; Taur, Y.; Jenq, R. R.; Equinda, M. J.; Son, T.; Samstein, M.; Viale, A.; Socci, N. D.; van den Brink, M. R. M.; Kamboj, M.; Pamer, E. G.
Article Title:	Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humans
Abstract:	Bloodstream infection by highly antibiotic-resistant bacteria, such as vancomycin-resistant Enterococcus (VRE), is a growing clinical problem that increasingly defies medical intervention. Identifying patients at high risk for bacterial sepsis remains an important clinical challenge. Recent studies have shown that antibiotics can alter microbial diversity in the intestine. Here, we characterized these effects using 16s rDNA pyrosequencing and demonstrated that antibiotic treatment of mice enabled exogenously administered VRE to efficiently and nearly completely displace the normal microbiota of the small and large intestine. In the clinical setting, we found that intestinal domination by VRE preceded bloodstream infection in patients undergoing allogeneic hematopoietic stem cell transplantation. Our results demonstrate that antibiotics perturb the normal commensal microbiota and set the stage for intestinal domination by bacteria associated with hospital-acquired infections. Thus, high-throughput DNA sequencing of the intestinal microbiota could identify patients at high risk of developing bacterial sepsis.
Keywords:	clinical article; controlled study; antibiotic agent; antibiotic therapy; nonhuman; mouse; animals; mice; animal tissue; animal experiment; animal model; hematopoietic stem cell transplantation; mice, inbred c57bl; antibiotic resistance; anti-bacterial agents; allogeneic hematopoietic stem cell transplantation; base sequence; bacteremia; enterococcus; vancomycin resistance; bacterial colonization; bloodstream infection; vancomycin resistant enterococcus; gram-positive bacterial infections; vancomycin; intestine flora; metronidazole; dna, bacterial; intestines; cross infection; cecum; ileum; pyrosequencing; neomycin; ampicillin; dna 16s; dna, ribosomal; metagenome
Journal Title:	Journal of Clinical Investigation
Volume:	120
Issue:	12
ISSN:	0021-9738
Publisher:	American Society for Clinical Investigation
Date Published:	2010-12-01
Start Page:	4332
End Page:	4341
Language:	English
DOI:	10.1172/jci43918
PUBMED:	21099116
PROVIDER:	scopus
PMCID:	PMC2993598
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-78649895980&partnerID=40&md5=35001594c58ba09d448ad277b8904923
Notes:	--- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: JCINA" - "Source: Scopus"

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