Vancomycin-resistant Enterococcus co-colonization rates with methicillin-resistant Staphylococcus aureus and Clostridium difficile in critically ill veterans

McKinley, Linda; Becerra, Benjamin J.; Moriarty, Helene; Short, Thomas H.; Hagle, Mary; Reymann, Abigail; Valentine, Susan; Duster, Megan; Warrack, Simone; Safdar, Nasia

doi:10.1016/j.ajic.2016.02.005

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…The microbiota in C. difficile conditioned medium generally contained significantly over-represented opportunistic pathogens, particularly Enterococcus members. This is in agreement with several other studies that found association between C. difficile colonization/infection and enterococci 44 , 49 or vancomycin-resistant enterococci (VRE) 50 – 53 . VRE colonization was also described as a risk factor for CDI recurrence 51 , 52 .…”

Section: Discussionsupporting

confidence: 93%

Evaluating the effect of Clostridium difficile conditioned medium on fecal microbiota community structure

Horvat

Mahnič

Breskvar

et al. 2017

Sci Rep

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Clostridium difficile infection (CDI) is typically associated with disturbed gut microbiota and changes related to decreased colonization resistance against C. difficile are well described. However, nothing is known about possible effects of C. difficile on gut microbiota restoration during or after CDI. In this study, we have mimicked such a situation by using C. difficile conditioned medium of six different C. difficile strains belonging to PCR ribotypes 027 and 014/020 for cultivation of fecal microbiota. A marked decrease of microbial diversity was observed in conditioned medium of both tested ribotypes. The majority of differences occurred within the phylum Firmicutes, with a general decrease of gut commensals with putative protective functions (i.e. Lactobacillus, Clostridium_XIVa) and an increase in opportunistic pathogens (i.e. Enterococcus). Bacterial populations in conditioned medium differed between the two C. difficile ribotypes, 027 and 014/020 and are likely associated with nutrient availability. Fecal microbiota cultivated in medium conditioned by E. coli, Salmonella Enteritidis or Staphylococcus epidermidis grouped together and was clearly different from microbiota cultivated in C. difficile conditioned medium suggesting that C. difficile effects are specific. Our results show that the changes observed in microbiota of CDI patients are partially directly influenced by C. difficile.

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Section: Discussionsupporting

confidence: 93%

Evaluating the effect of Clostridium difficile conditioned medium on fecal microbiota community structure

Horvat

Mahnič

Breskvar

et al. 2017

Sci Rep

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“…Also, the presence of Sutterella was linked to several other human diseases, where gut microbiota seems to play a crucial role in their development (e.g., metabolic syndrome and autism) ( Wang et al, 2013 ; Lim et al, 2017 ). An association between C. difficile colonization/infection and enterococci or vancomycin-resistant enterococci (VRE) is also well documented ( Ozaki et al, 2004 ; Choi et al, 2011 ; Fujitani et al, 2011 ; Stripling et al, 2015 ; McKinley et al, 2016 ). Moreover, our previous study demonstrated undisturbed growth of representative strain of Enterococcus in co-culture with C. difficile on agar plates ( Horvat et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Interactions Between Clostridioides difficile and Fecal Microbiota in in Vitro Batch Model: Growth, Sporulation, and Microbiota Changes

Horvat

Rupnik

2018

Front. Microbiol.

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Disturbance in gut microbiota is crucial for the development of Clostridioides difficile infection (CDI). Different mechanisms through which gut microbiota influences C. difficile colonization are known. However, C. difficile could also affect gut microbiota balance as previously demonstrated by cultivation of fecal microbiota in C. difficile conditioned medium. In current study, the interactions of C. difficile cells with gut microbiota were addressed. Three different strains (ribotypes 027, 014/020, and 010) were co-cultivated with two types of fecal microbiota (healthy and dysbiotic) using in vitro batch model. While all strains showed higher sporulation frequency in the presence of dysbiotic fecal microbiota, the growth was strain dependent. C. difficile either proliferated to comparable levels in the presence of dysbiotic and healthy fecal microbiota or grew better in co-culture with dysbiotic microbiota. In co-cultures with any C. difficile strain fecal microbiota showed decreased richness and diversity. Dysbiotic fecal microbiota was more affected after co-culture with C. difficile than healthy microbiota. Altogether, 62 OTUs were significantly changed in co-cultures of dysbiotic microbiota/C. difficile and 45 OTUs in co-cultures of healthy microbiota/C. difficile. However, the majority of significantly changed OTUs in both types of microbiota belonged to the phylum Firmicutes with Lachnospiraceae and Ruminococcaceae origin.

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“…This definition was previously used by Flannery et al when investigating MRSA and VRE co-colonization among long-stay NF populations with indwelling devices, 20 and by requiring same day isolation of organisms it is more conservative than those used in other studies investigating co-colonization in acute care settings. 9,[11][12][13]20 Statistical Analysis…”

Section: Colonization Definitionsmentioning

confidence: 99%

“…[8][9][10] In the majority of VRSA cases, VR E. faecalis has been the vanA donor vs other VRE species, and in order to facilitate conjugation, both bacterial species must be in close proximity to each other by cocolonizing a single site of a patient's body. 9,10 While patterns of MRSA and VRE cocolonization have been studied in hospitalized patients, 9,[11][12][13] other healthcare settings may present unique environments for the dissemination of resistance to occur. Specifically, nursing facilities (NFs) are known reservoirs for multi-drug resistant organisms (MDROs) with an estimated one-third of all NF patients being colonized with one or more MDROs.…”

Section: Introductionmentioning

confidence: 99%

Predictors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization among nursing facility patients

Heinze

Kabeto

Martin

et al. 2019

American Journal of Infection Control

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Background: The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) poses significant challenges for antibiotic therapy. We characterized the epidemiology of methicillinresistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) cocolonization that may facilitate resistance transfer and VRSA emergence among nursing facility (NF) patients. Methods: We cultured newly admitted patient hands, nares, oropharynx, groin, perianal region, plus wounds and device insertion sites if applicable upon enrollment, at day 14, day 30, and monthly thereafter for up to 6 months. Demographic, comorbidity, and antimicrobial use data was collected. Functional status was assessed at each visit using the Lawton & Brody Physical Self Maintenance Scale. Multinomial logistic regression was performed using a generalized linear mixed effect model to determine factors predictive of co-colonization. Results: 508 patients were enrolled with an average follow-up time of 28.5 days. Prevalence of MRSA/VRE cocolonization, MRSA alone, and VRE alone were 8.7%, 8.9%, and 23.4% respectively. Independent predictors of co-colonization included indwelling device use [OR=5.5

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Vancomycin-resistant Enterococcus co-colonization rates with methicillin-resistant Staphylococcus aureus and Clostridium difficile in critically ill veterans

Cited by 11 publications

References 14 publications

Evaluating the effect of Clostridium difficile conditioned medium on fecal microbiota community structure

Evaluating the effect of Clostridium difficile conditioned medium on fecal microbiota community structure

Interactions Between Clostridioides difficile and Fecal Microbiota in in Vitro Batch Model: Growth, Sporulation, and Microbiota Changes

Predictors of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization among nursing facility patients

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