CONCISE COMMUNICATION Inhibition of Vancomycin-Resistant Enterococci by an In Vitro Continuous-Flow Competitive Exclusion Culture Containing Human Stool Flora

Content Provider	CiteSeerX
Author	Stokes, Louis Callaway, Todd R. Hoyen, Claudia K. Hume, Michael E. Donskey, Curtis J. Das, Sarbani M. Rice, Louis B.
Abstract	An in vitro anaerobic continuous-flow competitive exclusion (CFCE) culture model was used to study the ability of human stool flora to inhibit the growth of vancomycin-resistant (VR) enterococci (VRE). The CFCE culture was established from a stool sample obtained from a healthy adult. When 103 or 106 cfu/mL of VR Enterococcus faecium were added to the CFCE culture, the VRE were eliminated within 6 or 9 days, respectively. When 107 cfu/mL of the CFCE culture was added to a continuous-flow culture that contained 107 cfu/mL of VRE, the density of VRE was reduced but not eliminated. These data support the hypothesis that the indigenous intestinal flora inhibit growth of VRE and suggest that CFCE cultures may be a useful means to study interactions between the indigenous flora and VRE. The intestinal tract is an important source for the spread of vancomycin-resistant enterococci (VRE), and fecal colonization may persist for months in many patients [1]. In mice [2] and in colonized patients [1], we demonstrated that antibiotics with activity against anaerobes promote intestinal overgrowth of VRE, whereas antibiotics with minimal antianaerobic activity
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