β-Lactam Antibiotics and Gastrointestinal Colonization with Vancomycin-Resistant Enterococci

We studied the effect of different subcutaneously administered β-lactam antibiotics on the establishment of gastrointestinal colonization by vancomycin-resistant Enterococcus faecium C68 in a mouse model. Aztreonam, cefazolin, cefepime, and, to a lesser extent, ceftazidime, which neither have signif...

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Bibliographic Details
Published in:The Journal of infectious diseases 2004-03, Vol.189 (6), p.1113-1118
Main Authors: Rice, Louis B., Thomas, Rebecca Hutton, Lakticova, Viera, Helfand, Marion S., Donskey, Curtis J.
Format: Article
Language:English
Subjects:
Anaerobic bacteria
Animals
Anti-Bacterial Agents - pharmacokinetics
Anti-Bacterial Agents - pharmacology
Antibiotics
Antimicrobials
Bacteria
Bacterial colonization
Bacteriology
Bedding
beta-Lactams - pharmacology
Bile
Bile - metabolism
Biological and medical sciences
Digestive System - microbiology
Enterococcus faecium
Enterococcus faecium - drug effects
Female
Fundamental and applied biological sciences. Psychology
Health care administration
Infections
Infectious diseases
Medical sciences
Mice
Microbial colonization
Microbiology
Miscellaneous
Vancomycin Resistance
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Summary:We studied the effect of different subcutaneously administered β-lactam antibiotics on the establishment of gastrointestinal colonization by vancomycin-resistant Enterococcus faecium C68 in a mouse model. Aztreonam, cefazolin, cefepime, and, to a lesser extent, ceftazidime, which neither have significant antienterococcal activity nor are secreted into human bile at high concentrations, did not promote significant vancomycin-resistant enterococci (VRE) colonization. Piperacillin-tazobactam, which has antienterococcal activity and is secreted in human bile at high concentrations, inhibited colonization after limited exposure to the inoculum but was associated with progressively increased VRE colony counts in stool samples after repeated exposure to the VRE inoculum. Ceftriaxone and cefotetan, which lack antienterococcal activity but are secreted into human bile at high concentrations, were associated with rapid and high-level colonization. These data suggest that the risk of VRE colonization varies during exposure to different β-lactam antimicrobial agents and that the risk is related to biliary concentration and antienterococcal activity of the specific β-lactam.
ISSN:0022-1899
1537-6613
DOI:10.1086/382086