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Gastrointestinal transit survival of an Enterococcus faecium probiotic strain administered with or without vancomycin
Södertörn University, Avdelning Naturvetenskap. Huddinge University Hospital, Karolinska Institutet.
Huddinge University Hospital, Karolinska Institutet.
Södertörn University, Avdelning Naturvetenskap. Huddinge University Hospital, Karolinska Institutet.
2002 (English)In: International Journal of Food Microbiology, ISSN 0168-1605, E-ISSN 1879-3460, Vol. 77, no 1-2, 109-115 p.Article in journal (Refereed) Published
Abstract [en]

The primary aim of this study was to evaluate if an ingested probiotic, containing viable Enterococcus faecium could survive gastrointestinal transit and if so, correlate the amount of the recovered probiotic strain with the host's own enterococci. The second aim was to investigate if simultaneous vancomycin intake influenced the survival and persistence of the probiotic strain and the stability of endogenous enterococci strains. Twenty healthy volunteers were given the probiotic product once daily for 10 days. Half of the subjects were simultaneously given vancomycin. Isolates of E. faecium strains were genotypically or phenotypically analysed with pulsed-field gel electrophoresis (PFGE) and the PhenePlate(TM) system, respectively. In eight of the ten volunteers given only the probiotic, the ingested E. faecium could be detected on day 10, while in none on day 31. From subjects given both probiotic and vancomycin no ingested E. faecium could be detected on day 10 or day 31. The estimated amount of ingested E. faecium recovered from faeces on day 10 ranged from 1.2 x 10(3) to 4.2 x 10(6) colony forming units per gram faeces, which in several cases were a substantial part of the total amount of E. faecium. The E. faecium isolated before probiotic plus vancomycin administration showed no close relationship to the ones isolated 3 weeks after ceased intake in any subjects. In conclusion, the ingested E. faecium strain can survive gastrointestinal transit. After intake, the E. faecium probiotic strain might become a large part of the total E, faecium population. The occurrence of the probiotic strain in the human gut seems to be transient after intake stop. Re-colonization of E. faecium after simultaneous probiotic plus vancomycin intake occurs mainly with strains without close genetic relationship to the strains harboured before treatment or to the ingested E. faecium strain.

Place, publisher, year, edition, pages
2002. Vol. 77, no 1-2, 109-115 p.
National Category
Microbiology
Identifiers
URN: urn:nbn:se:sh:diva-15792DOI: 10.1016/S0168-1605(02)00047-8ISI: 000176056800012PubMedID: 12076027Scopus ID: 2-s2.0-0037173481OAI: oai:DiVA.org:sh-15792DiVA: diva2:508462
Available from: 2012-03-08 Created: 2012-03-07 Last updated: 2017-02-15Bibliographically approved
In thesis
1. Different roles of enterococcus faecium from a human perspective
Open this publication in new window or tab >>Different roles of enterococcus faecium from a human perspective
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Food supplements containing viable bacteria, so called probiotics, have been suggested to have beneficial health effects due to their influence on the normal microflora. However, there has been safety concern regarding probiotics containing Enterococcus faecium. Although part of the normal intestinal microflora in humans, enterococci can cause infections such as urinary tract infections, septicaemia, and endocarditis. Enterococci are also inclined to develop antibiotic resistance and their hardy nature promotes survival and dissemination in the hospital setting. Although the importance of E.faecium as a bloodstream isolate is increasing, little regarding its virulence is known. One virulence trait attributed to E. faecium is the enterococcal surface protein, Esp, encoded by the esp gene. Since enterococci have different roles from the human perspective, such as occurrence in food, as probiotic strains, members of the normal intestinal microflora, and as the cause of nosocomial infections, it is important to study differences and similarities between strains of different origin. The aims of the present investigation were to study some safety aspects of a probiotic product containing Efaecium, the colonization and transmission of enterococci from a nosocomial perspective, and differences between E.faecium isolates of different origin in some characteristics of probable importance for virulence. Faecal samples were collected from healthy volunteers administered an E. faecium probiotic. Half of the volunteers received simultaneous peroral vancomycin. The E. faecium isolates were subtyped and an in vitro conjugation assay was performed. The investigated strain could survive gastrointestinal transit in humans, and intake temporarily increased the number of enterococci in the faecal microflora. The vancomycin administration prevented detection of the probiotic strain. The probiotic strain could gain the vanA gene cluster under in vitro conditions. Samples from the respiratory tract and stomach were collected from 20 consecutive patients undergoing mechanical ventilation. The enterococci isolated were subsequently subtyped. Seventeen of the 20 subjects were colonized with enterococci in the respiratory tract. Genotype analyses suggested that 13 patients were involved in a transmission event, including all patients intubated more than 12 days. The E. faecium isolates were more resistant to antimicrobial agents compared to E. faecalis. The E. faecium isolates from different origins, i.e., infections, faeces, and probiotic products, were investigated for the presence of esp, their ability to conjugate, and adhere to epithelial cells in vitro. The esp gene was significantly more common among blood isolates. E. faecium strains enriched with esp adhered significantly better, were less genetically diverse, and had a higher conjugation frequency compared to esp-negative blood isolates. Antibiotic resistance was only detected among the infection-derived isolates. The adhesion among esp-negative isolates from the normal microflora was higher compared to the esp-negative bacteraemia isolates. In conclusion, the investigated probiotic E. faecium strain can survive gastrointestinal transit in humans, and intake may transiently increase the number of enterococci in the faecal microflora. The same strain can gain the vanA operon. Enterococci are frequently disseminated between mechanically ventilated patients, and isolates from different subpopulations seem to have different characteristics in terms of occurrence of esp, adhesion properties, antibiotic resistance, and conjugation frequencies.

Place, publisher, year, edition, pages
Stockholm: Karolinska Instiutet, 2003. 79 p.
National Category
Biological Sciences
Identifiers
urn:nbn:se:sh:diva-32071 (URN)91-7349-607-3 (ISBN)
Public defence
2003-10-15, Birkeaulan 2, F-huset, plan 5, Huddinge Universitetssjukhus, Huddinge, 10:00 (English)
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Available from: 2017-02-15 Created: 2017-02-15 Last updated: 2017-02-15Bibliographically approved

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