期刊
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
卷 55, 期 6, 页码 2585-2589出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/AAC.00891-10
关键词
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资金
- Department of Veterans Affairs
- National Institutes of Health [RO1-AI63517, RO3-AI081036]
- Steris Corporation
- VISN-10 Geriatric Research, Education, and Clinical Center
An understanding of the impact of antibiotics on the intestinal reservoir of KPC carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) is important to prevent its emergence. We used a mouse model to examine the effect of antibiotic treatment on the establishment and elimination of intestinal colonization with KPC-Kp. Mice (10 per group) received subcutaneous antibiotics daily for 8 days. On day 3 of treatment, 103 CFU of KPC-Kp was given orogastrically, and concentrations of KPC-Kp in stool were monitored. Additional experiments assessed the effects of antibiotic treatment on concentrations of total anaerobes and Bacteroides spp. in stool and the efficacy of orogastric gentamicin and polymyxin E in suppressing KPC-Kp colonization. Of four antibiotics with minimal activity against the KPC-Kp test strain (MIC >= 16 mu g/ml), those that suppressed total anaerobes and bacteroides (i.e., clindamycin and piperacillin-tazobactam) promoted colonization by KPC-Kp (P < 0.001), whereas agents that did not suppress total anaerobes or bacteroides (i.e., ciprofloxacin and cefepime) did not (P = 0.35). Of two agents with moderate activity against the KPC-Kp test strain, ertapenem (MIC, 4 mu g/ml) did not promote colonization by KPC-Kp, whereas tigecycline (MIC, 3 mu g/ml) did (P < 0.001), despite not reducing levels of total anaerobes or bacteroides. Orogastric treatment with gentamicin and polymyxin E suppressed KPC-Kp to undetectable levels in the majority of mice. These data suggest that antibiotics that disturb the intestinal anaerobic microflora and lack significant activity against KPC-Kp promote colonization by this organism. The administration of nonabsorbed oral antibiotics may be an effective strategy to suppress colonization with KPC-Kp.
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