Influence of Oral Glycopeptides on the Fecal Flora of Human Volunteers: Selection of Highly Glycopeptide-Resistant Enterococci

• Published in: The Journal of infectious diseases Vol. 173; no. 5; pp. 1129 - 1136
• Main Authors: Van der Auwera, Philippe, Pensart, Nelly, Korten, Volkan, Murray, Barbara E., Leclercq, Roland
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-05-1996; University of Chicago Press; Oxford University Press
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacology; Bacterial Proteins - genetics; Belgium; Biological and medical sciences; Carbon-Oxygen Ligases; DNA probes; DNA Transposable Elements - genetics; Drug Resistance, Microbial; Drug toxicity and drugs side effects treatment; Enterococcus; Enterococcus - drug effects; Enterococcus - genetics; Enterococcus - isolation & purification; Enterococcus faecium; Enterococcus faecium - drug effects; Enterococcus faecium - genetics; Enterococcus faecium - isolation & purification; Fecal flora; Feces - microbiology; Female; Flora; Genes, Bacterial; Glycopeptides; Health care administration; Humans; Ligases - genetics; Major Articles; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Pharmacology. Drug treatments; Polymorphism, Restriction Fragment Length; Staphylococcus; Streptococcaceae - drug effects; Streptococcaceae - isolation & purification; Teicoplanin - administration & dosage; Teicoplanin - pharmacology; Toxicity: digestive system; Transposons; Vancomycin - administration & dosage; Vancomycin - pharmacology; Volunteerism; Belgium; Human; Antibiotic; Glycopeptide; Polypeptide; Toxicity; Gut; Oral administration; Microflora; Biological activity
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/173.5.1129

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 Enterococcusfaecium) 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 cfulg) 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.