Cooperating Commensals Restore Colonization Resistance to Vancomycin-Resistant Enterococcus faecium

Cell Host Microbe. 2017 May 10;21(5):592-602.e4. doi: 10.1016/j.chom.2017.04.002.


Antibiotic-mediated microbiota destruction and the consequent loss of colonization resistance can result in intestinal domination with vancomycin-resistant Enterococcus (VRE), leading to bloodstream infection in hospitalized patients. Clearance of VRE remains a challenging goal that, if achieved, would reduce systemic VRE infections and patient-to-patient transmission. Although obligate anaerobic commensal bacteria have been associated with colonization resistance to VRE, the specific bacterial species involved remain undefined. Herein, we demonstrate that a precisely defined consortium of commensal bacteria containing the Clostridium cluster XIVa species Blautia producta and Clostridium bolteae restores colonization resistance against VRE and clears VRE from the intestines of mice. While C. bolteae did not directly mediate VRE clearance, it enabled intestinal colonization with B. producta, which directly inhibited VRE growth. These findings suggest that therapeutic or prophylactic administration of defined bacterial consortia to individuals with compromised microbiota composition may reduce inter-patient transmission and intra-patient dissemination of highly antibiotic-resistant pathogens.

Keywords: Blautia product; Enterococcus; Enterococcus faecium; antibiotic resistance; colonization resistance; commensal bacteria; intestinal domination; microbiome; microbiota; vancomycin resistance.

MeSH terms

  • Ampicillin / pharmacology
  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Bacteria / genetics
  • Bacteria / isolation & purification
  • Bacterial Physiological Phenomena
  • Clostridium / physiology
  • Colony Count, Microbial
  • DNA, Bacterial
  • Drug Resistance, Bacterial
  • Enterococcus faecium / growth & development*
  • Enterococcus faecium / pathogenicity
  • Feces / microbiology
  • Female
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / prevention & control
  • Intestines / microbiology
  • Mice
  • Mice, Inbred C57BL
  • Microbiota / physiology*
  • RNA, Ribosomal, 16S / genetics
  • Symbiosis / physiology*
  • Vancomycin / pharmacology
  • Vancomycin-Resistant Enterococci / genetics
  • Vancomycin-Resistant Enterococci / growth & development*
  • Vancomycin-Resistant Enterococci / pathogenicity


  • Anti-Bacterial Agents
  • DNA, Bacterial
  • RNA, Ribosomal, 16S
  • Vancomycin
  • Ampicillin