Influence of oral glycopeptides on the fecal flora of human volunteers: selection of highly glycopeptide-resistant enterococci

J Infect Dis. 1996 May;173(5):1129-36. doi: 10.1093/infdis/173.5.1129.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics
  • Belgium
  • Carbon-Oxygen Ligases*
  • DNA Transposable Elements / genetics
  • Drug Resistance, Microbial
  • Enterococcus / drug effects*
  • Enterococcus / genetics
  • Enterococcus / isolation & purification
  • Enterococcus faecium / drug effects
  • Enterococcus faecium / genetics
  • Enterococcus faecium / isolation & purification
  • Feces / microbiology*
  • Female
  • Genes, Bacterial
  • Humans
  • Ligases / genetics
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Polymorphism, Restriction Fragment Length
  • Streptococcaceae / drug effects
  • Streptococcaceae / isolation & purification
  • Teicoplanin / administration & dosage
  • Teicoplanin / pharmacology*
  • Vancomycin / administration & dosage
  • Vancomycin / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • DNA Transposable Elements
  • VanA ligase, Bacteria
  • Teicoplanin
  • Vancomycin
  • Ligases
  • Carbon-Oxygen Ligases