Loss of microbiota-mediated colonization resistance to Clostridium difficile infection with oral vancomycin compared with metronidazole Journal Article


Authors: Lewis, B. B.; Buffie, C. G.; Carter, R. A.; Leiner, I.; Toussaint, N. C.; Miller, L. C.; Gobourne, A.; Ling, L.; Pamer, E. G.
Article Title: Loss of microbiota-mediated colonization resistance to Clostridium difficile infection with oral vancomycin compared with metronidazole
Abstract: Antibiotic administration disrupts the intestinal microbiota, increasing susceptibility to pathogens such as Clostridium difficile. Metronidazole or oral vancomycin can cure C. difficile infection, and administration of these agents to prevent C. difficile infection in high-risk patients, although not sanctioned by Infectious Disease Society of America guidelines, has been considered. The relative impacts ofmetronidazole and vancomycin on the intestinal microbiota and colonization resistance are unknown. We investigated the effect of brief treatment with metronidazole and/or oral vancomycin on susceptibility to C. difficile, vancomycin-resistant Enterococcus, carbapenem-resistant Klebsiella pneumoniae, and Escherichia coli infection in mice. Although metronidazole resulted in transient loss of colonization resistance, oral vancomycin markedly disrupted the microbiota, leading to prolonged loss of colonization resistance to C. difficile infection and dense colonization by vancomycin-resistant Enterococcus, K. pneumoniae, and E. coli. Our results demonstrate that vancomycin, and to a lesser extent metronidazole, are associated with marked intestinal microbiota destruction and greater risk of colonization by nosocomial pathogens. © The Author 2015.
Keywords: vancomycin; metronidazole; clostridium difficile; microbiota; colonization resistance
Journal Title: Journal of Infectious Diseases
Volume: 212
Issue: 10
ISSN: 0022-1899
Publisher: Oxford University Press  
Date Published: 2015-11-15
Start Page: 1656
End Page: 1665
Language: English
DOI: 10.1093/infdis/jiv256
PROVIDER: scopus
PMCID: PMC4621244
PUBMED: 25920320
DOI/URL:
Notes: Article -- Export Date: 1 September 2016 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Eric Pamer
    266 Pamer
  2. Ingrid Leiner
    48 Leiner
  3. Charlie G Buffie
    7 Buffie
  4. Lilan Ling
    40 Ling
  5. Rebecca Anne Carter
    12 Carter
  6. Liza Claire Miller
    7 Miller
  7. Brittany   Lewis
    6 Lewis