Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci

Vancomycin is frequently used for the treatment of <i>C. difficile</i> infections (CDI). There are concerns that this might increase the risk of selecting vancomycin resistant enterococci (VRE). Here, we evaluated whether there is an increased risk of VRE acquisition following vancomycin...

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Autores principales: Carlos L. Correa-Martínez, Niklas C. J. Hagemeier, Neele J. Froböse, Stefanie Kampmeier
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
Materias:
CDI
VRE
R
Acceso en línea:https://doaj.org/article/19921aa1bb474ee3adf18d88cd120d7b
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spelling oai:doaj.org-article:19921aa1bb474ee3adf18d88cd120d7b2021-11-25T18:39:03ZImpact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci10.3390/ph141110661424-8247https://doaj.org/article/19921aa1bb474ee3adf18d88cd120d7b2021-10-01T00:00:00Zhttps://www.mdpi.com/1424-8247/14/11/1066https://doaj.org/toc/1424-8247Vancomycin is frequently used for the treatment of <i>C. difficile</i> infections (CDI). There are concerns that this might increase the risk of selecting vancomycin resistant enterococci (VRE). Here, we evaluated whether there is an increased risk of VRE acquisition following vancomycin for CDI specific treatment. Patients with CDI, metronidazole, or oral vancomycin treatment and without preexisting VRE were monitored for VRE acquisition. VRE isolates from patients with acquired and preexisting colonization were collected and subjected to whole genome sequencing. In total, 281 patients (median age 56 years, 54% of the male sex) presented with toxin positive <i>C. difficile</i>. Of them, 170 patients met the inclusion criteria, comprising 37 patients treated with metronidazole and 133 treated with oral vancomycin. In total, 14 patients meeting the inclusion criteria acquired VRE (vancomycin: <i>n</i> = 11; metronidazole: <i>n</i> = 3). Statistical analysis revealed no significant differences between both VRE acquisition rates. Genetic comparison of detected VRE isolates resulted in eight clusters of closely related genotypes comprising acquired and preexisting strains. Our results suggest that vancomycin and metronidazole likewise increase the risk of VRE acquisition. Genetic comparison indicates that VRE acquisition is a result of both antibiotic selection and pathogen transmission.Carlos L. Correa-MartínezNiklas C. J. HagemeierNeele J. FroböseStefanie KampmeierMDPI AGarticleCDIVREantimicrobial stewardshipwhole genome sequencingMedicineRPharmacy and materia medicaRS1-441ENPharmaceuticals, Vol 14, Iss 1066, p 1066 (2021)
institution DOAJ
collection DOAJ
language EN
topic CDI
VRE
antimicrobial stewardship
whole genome sequencing
Medicine
R
Pharmacy and materia medica
RS1-441
spellingShingle CDI
VRE
antimicrobial stewardship
whole genome sequencing
Medicine
R
Pharmacy and materia medica
RS1-441
Carlos L. Correa-Martínez
Niklas C. J. Hagemeier
Neele J. Froböse
Stefanie Kampmeier
Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
description Vancomycin is frequently used for the treatment of <i>C. difficile</i> infections (CDI). There are concerns that this might increase the risk of selecting vancomycin resistant enterococci (VRE). Here, we evaluated whether there is an increased risk of VRE acquisition following vancomycin for CDI specific treatment. Patients with CDI, metronidazole, or oral vancomycin treatment and without preexisting VRE were monitored for VRE acquisition. VRE isolates from patients with acquired and preexisting colonization were collected and subjected to whole genome sequencing. In total, 281 patients (median age 56 years, 54% of the male sex) presented with toxin positive <i>C. difficile</i>. Of them, 170 patients met the inclusion criteria, comprising 37 patients treated with metronidazole and 133 treated with oral vancomycin. In total, 14 patients meeting the inclusion criteria acquired VRE (vancomycin: <i>n</i> = 11; metronidazole: <i>n</i> = 3). Statistical analysis revealed no significant differences between both VRE acquisition rates. Genetic comparison of detected VRE isolates resulted in eight clusters of closely related genotypes comprising acquired and preexisting strains. Our results suggest that vancomycin and metronidazole likewise increase the risk of VRE acquisition. Genetic comparison indicates that VRE acquisition is a result of both antibiotic selection and pathogen transmission.
format article
author Carlos L. Correa-Martínez
Niklas C. J. Hagemeier
Neele J. Froböse
Stefanie Kampmeier
author_facet Carlos L. Correa-Martínez
Niklas C. J. Hagemeier
Neele J. Froböse
Stefanie Kampmeier
author_sort Carlos L. Correa-Martínez
title Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
title_short Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
title_full Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
title_fullStr Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
title_full_unstemmed Impact of <i>Clostridioides difficile</i> Therapy on Nosocomial Acquisition of Vancomycin-Resistant Enterococci
title_sort impact of <i>clostridioides difficile</i> therapy on nosocomial acquisition of vancomycin-resistant enterococci
publisher MDPI AG
publishDate 2021
url https://doaj.org/article/19921aa1bb474ee3adf18d88cd120d7b
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AT niklascjhagemeier impactoficlostridioidesdifficileitherapyonnosocomialacquisitionofvancomycinresistantenterococci
AT neelejfrobose impactoficlostridioidesdifficileitherapyonnosocomialacquisitionofvancomycinresistantenterococci
AT stefaniekampmeier impactoficlostridioidesdifficileitherapyonnosocomialacquisitionofvancomycinresistantenterococci
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