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Gut microbiome features associated with vancomycin-resistant Enterococcus acquisition in intensive care unit patients
Yu-Chung Chuang1, Ronald G Collman2,3, Sheng-Yuan Ruan4
1Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 100226, Taiwan. weischuang@gmail.com.
Annals of Clinical Microbiology and Antimicrobials
|June 3, 2026
Summary
Vancomycin-resistant Enterococcus (VRE) acquisition in ICUs is linked to gut microbiome changes. Lower Bacteroides/Enterococcus ratios and specific bile acids are associated with VRE colonization risk.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Vancomycin-resistant Enterococcus (VRE) infections are a major ICU burden.
- Gut colonization precedes VRE infection.
- The gut microbiome's role in VRE susceptibility is not fully understood in ICU settings.
Purpose of the Study:
- To investigate the association between gut microbiome composition and VRE acquisition in ICU patients.
- To identify specific microbial and metabolic markers predictive of VRE colonization.
Main Methods:
- Prospective study of 108 ICU patients.
- 16S rRNA gene sequencing of stool samples.
- VRE screening via anal swabs and bile acid measurement.
Main Results:
- VRE acquisition was linked to lower alpha-diversity and altered beta-diversity.
- Reduced Bacteroides/Enterococcus ratio and low Clostridium scindens abundance correlated with VRE acquisition.
- Lower concentrations of deoxycholic and lithocholic acids were observed in patients acquiring VRE.
Conclusions:
- Gut microbiome features like low Bacteroides/Enterococcus ratio, reduced C. scindens, and specific bile acids may play a role in VRE colonization resistance.
- Findings suggest potential for microbiome-based strategies to prevent VRE.
- Further validation is needed due to the single-center design.
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