Abstract
BackgroundEnterococci, and especially multiresistant Enterococcus faecium, are increasingly found colonizing hospitalized patients. This increased prevalence of colonization is not only associated with an increased prevalence of infections caused by enterococci, but also by infections with other nosocomial pathogens. In this study we investigated the causality of this observed relationship, by determining the influence of intestinal colonization with E. faecium on pulmonary defense against Pseudomonas aeruginosa.Methodology/Principal FindingsThree groups of mice were tested; 2 groups of mice were pre-treated with vancomycin, of which one group was subsequently treated by oral gavage of vancomycin-resistant E. faecium (VRE). The third group did not receive any pre-treatment. P. aeruginosa pneumonia was induced in all mice. Vancomycin treatment resulted in intestinal gram-negative bacterial overgrowth and VRE treatment resulted in colonization throughout the intestines. All 3 groups of mice were able to clear P. aeruginosa from the lungs and circulation, with comparable lung cytokine responses and lung damage. Mice treated with vancomycin without VRE colonization displayed modestly increased plasma levels of TNF-α and IL-10.ConclusionOvergrowth of E. faecium and/or gram-negative bacteria does not impact importantly on pulmonary defense against P. aeruginosa pneumonia.
Highlights
Hospitalized patients become increasingly colonized with multiresistant Enterococcus faecium
Intestinal E. faecium colonization The intestinal track of mice receiving vancomycin in combination with oral E. faecium was successfully colonized with vancomycin-resistant E. faecium (VRE)
In this experimental group 1, high VRE loads were cultured from jejunum, cecum and colon directly before induction of pneumonia (Table 1)
Summary
Hospitalized patients become increasingly colonized with multiresistant Enterococcus faecium This is mainly observed in patients treated with antibiotics not effective against E. faecium on nephrology, ICU, hematology and transplantation wards [1,2]. Colonization with this opportunistic pathogen has been associated with an increased incidence of infections with E. faecium [3,4], and with other nosocomial pathogens including multiresistant gram-negative bacilli [5,6]. In this study we investigated the causality of this observed relationship, by determining the influence of intestinal colonization with E. faecium on pulmonary defense against Pseudomonas aeruginosa
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