Bowel colonization with vancomycin-resistant enterococci after antimicrobial therapy for intra-abdominal infections:...

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Pharmacology

Background:

• Intra-abdominal infections (IAIs) are common and require effective antimicrobial therapy.
• The emergence of vancomycin-resistant enterococci (VRE) poses a significant challenge in healthcare settings.
• Bowel colonization with VRE is a risk factor for VRE infections.

Purpose of the Study:

• To evaluate the impact of different antimicrobial regimens on VRE bowel colonization.
• To compare piperacillin-tazobactam, ceftriaxone/metronidazole, and ertapenem regarding VRE colonization.
• To inform antimicrobial selection for IAIs to minimize VRE selection pressure.

Main Methods:

• Two randomized open-label trials were conducted.
• Patients with intra-abdominal infections were randomized to receive specific antimicrobial treatments.
• VRE bowel colonization was assessed after treatment.

Main Results:

• Overall rates of VRE bowel colonization were comparable across treatment groups.
• Piperacillin-tazobactam, ceftriaxone/metronidazole, and ertapenem showed similar effects on VRE colonization.
• No significant difference in VRE colonization frequency was observed between the regimens.

Conclusions:

• The choice of antimicrobial regimen (piperacillin-tazobactam, ceftriaxone/metronidazole, or ertapenem) did not significantly alter the frequency of VRE bowel colonization in short-term studies.
• These findings suggest that current common antimicrobial choices for IAIs may have a similar impact on VRE selection in the gut.
• Further research may be needed to explore long-term effects and specific patient populations.