Influence of oral glycopeptides on the fecal flora of human volunteers: selection of highly glycopeptide-resistant enterococci.
Changes in fecal flora were evaluated in 22 healthy volunteers administered oral vancomycin or teicoplanin in 1989-1991 in Belgium. Evaluation of 5 colonies per subject revealed no glycopeptide-resistant enterococci in the predominant flora before glycopeptide administration; however, large numbers (mostly Enterococcus faecium) emerged by the end of the study in 14 (64%) of the subjects. Pediococci and lactobacilli also increased in number. In 1992, 40 healthy volunteers and 33 cancer patients were evaluated by plating stool samples directly onto selective media containing vancomycin; low numbers of vancomycin-resistant enterococci (< 50 cfu/g) were found in 11 (28%) of the 40 and 4 (12%) of the 33 samples, respectively. DNA restriction fragment length polymorphism analysis showed that most isolates were different, but all contained vanA in Tn1546-like elements. These results indicate that vanA and Tn1546-like elements were common in Belgium as early as 1989 and that community-based individuals in that location likely form a major reservoir for glycopeptide-resistant enterococci.
Van der Auwera
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P
Service de Médecine et Laboratoire d'Investigation Clinique H. J. Tagnon, (Clinique des Maladies Infectieuses et Laboratoire de Microbiologie), Institut Jules Bordet, Brussels, Belgium.
Pensart
N
N
Korten
V
V
Murray
B E
BE
Leclercq
R
R
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D001530:Belgium; D019729:Carbon-Oxygen Ligases; D004251:DNA Transposable Elements / Q000235:genetics; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008025:Ligases / Q000235:genetics; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D013289:Streptococcaceae / Q000187:drug effects / Q000302:isolation & purification; D017334:Teicoplanin / Q000008:administration & dosage / Q000494:pharmacology*; D014640:Vancomycin / Q000008:administration & dosage / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; C071437:VanA ligase, Bacteria; D017334:Teicoplanin; D014640:Vancomycin; D008025:Ligases; D019729:Carbon-Oxygen Ligases