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Alterations in human fecal flora, including ingrowth of Clostridium difficile, related to cefoxitin therapy
Abstract:
To evaluate the effects of parenteral cefoxitin therapy on human fecal flora, we cultured fecal specimens obtained from six patients before, during, and after therapy and used standard methods to identify and quantify all microorganisms. The major changes (observed in at least three patients) included the acquisition or proliferation of group D Streptococcus species, coagulase-negative Staphylococcus species, cefoxitin-resistant members of the family Enterobacteriaceae, Pseudomonas species, and various species of the Bacteroides fragilis group. The most striking finding was ingrowth of Clostridium difficile, noted in five of the six patients. There was concomitant eradication or decrease of cefoxitin-susceptible Enterobacteriaceae family members, Bacteroides species other than the B. fragilis group, Clostridium species other than C. difficile, and Lactobacillus species. These marked alterations of fecal flora may have important clinical consequences.
Insights
Parenteral cefoxitin therapy significantly altered human fecal flora, leading to the overgrowth of certain bacteria like Clostridium difficile. This antibiotic treatment also reduced beneficial bacteria, potentially causing adverse clinical effects.
Area of Science:
- Microbiology
- Pharmacology
- Gastroenterology
Background:
- Antibiotic therapy can disrupt the normal human gut microbiota.
- Understanding the impact of specific antibiotics on fecal flora is crucial for clinical practice.
Purpose of the Study:
- To investigate the effects of parenteral cefoxitin therapy on the composition of human fecal flora.
- To identify specific microbial changes associated with cefoxitin treatment.
Main Methods:
- Fecal specimens were collected from six patients before, during, and after cefoxitin therapy.
- Standard microbiological methods were used for microorganism identification and quantification.
Main Results:
- Cefoxitin therapy led to the proliferation of group D Streptococcus, coagulase-negative Staphylococcus, and cefoxitin-resistant Enterobacteriaceae.
- A significant increase in Clostridium difficile was observed in five of six patients.
- Susceptible Enterobacteriaceae, non-B. fragilis group Bacteroides, other Clostridium species, and Lactobacillus species were reduced.
Conclusions:
- Parenteral cefoxitin therapy causes profound alterations in human fecal flora.
- The observed microbial shifts, particularly the increase in Clostridium difficile, may have significant clinical implications.