Effects of probiotics on acquisition and spread of multiresistant enterococci
| Autor: | Rob J. L. Willems, Harald J. J. Verhaar, Titia E. M. Hopmans, Marc J. M. Bonten, Marieke J. A. de Regt, Ronald J. Hené, Peter D. Siersema |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Antibiotics Clinical Therapeutics law.invention Microbiology Probiotic law Internal medicine Ampicillin Drug Resistance Multiple Bacterial medicine Humans Pharmacology (medical) Prospective Studies Prospective cohort study Aged Pharmacology biology Probiotics Hazard ratio Vancomycin Resistance Middle Aged biology.organism_classification Crossover study Infectious Diseases Enterococcus Female Ampicillin Resistance Enterococcus faecium medicine.drug |
| Zdroj: | Antimicrobial agents and chemotherapy. 54(7) |
| ISSN: | 1098-6596 |
| Popis: | Ampicillin-resistant Enterococcus faecium (ARE) and vancomycin-resistant E. faecium (VRE) are important nosocomial pathogens. We quantified effects of probiotics and antibiotics on intestinal acquisition of ARE colonization in patients hospitalized in two non-intensive care unit (non-ICU) wards with high ARE prevalence. In a prospective cohort study with crossover design, all patients with a length of stay of >48 h were offered a multispecies probiotic product twice daily until discharge (4.5 months, intervention period) or not (4.5 months, control period). Perianal ARE carriage was determined 2 test, P = 0.325). In all, 661 ARE strains were isolated from 186 patients, of which 186 were genotyped. In both wards, two MLVA types (MTs; MT1 and MT159) were responsible for >80% of acquisitions. Both MTs were genetically different from the probiotic E. faecium strain. Antibiotics to which ARE is resistant (hazard ratio [HR], 7.73 [95% confidence interval (CI), 4.52 to 13.22]), an ecological postantibiotic effect (HR, 7.11 [95% CI, 3.10 to 16.30]), and age (HR, 1.01 [95% CI, 0.99 to 1.02]) were associated with ARE acquisition. The HR of probiotics was 1.43 (95% CI, 0.88 to 2.34). In a setting with high selective antibiotic pressure, probiotics failed to prevent acquisition of multiresistant enterococci. |
| Databáze: | OpenAIRE |
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