Antimicrobial susceptibility of Enterococcus strains used in clinical practice as probiotics
Tóm tắt
The aim of this study was to evaluate the antimicrobial susceptibilities of probiotic strains that are suggested to be effective for preventing antibiotics-associated diarrhea (AAD). The minimum inhibitory concentrations (MICs) of 17 antibiotics against probiotic strains were tested by the agar plate dilution method or broth microdilution method. In all, eight probiotic strains containing Enterococcus faecalis, Bifidobacterium spp., Clostridium butyricum, and Lactobacillus acidophilus were tested. Although the MIC range was wide, from less than 0.0625 to more than 1,024 μg/ml, the MICs of 11 beta-lactams were high for three of four enterococci, with a range of 32 to more than 1,024 μg/ml. In contrast, fluoroquinolones and vancomycin showed potent activities against all enterococci, of which MICs were 0.25–8 μg/ml. Two Bifidobacterium strains and one Lactobacillus strain showed low MICs against many of the beta-lactams, fluoroquinolones, macrolides, and vancomycin, with MICs of 8 μg/ml or less. Fosfomycin showed generally mild activity against enterococci (MIC, 8–32 μg/ml) and anaerobic strains (MIC, 32 to >1,024 μg/ml), respectively. The probiotics strains with high MIC values may survive in the intestinal tract, even if the patient was concomitantly using the antibiotics in clinical practice. Therefore, our results suggest that adequate combinations of probiotics strains and antibiotics should be important for preventing AAD. Further study is needed to determine the efficacy of probiotics in clinical practice.
Tài liệu tham khảo
Surawicz CM. Antibiotic-associated diarrhea and pseudomembranous colitis: are they less common with poorly absorbed antimicrobials? Chemotherapy. 2005;51(suppl 1):81–9.
Saavedra JM. Probiotics plus antibiotics: regulating our bacterial environment. J Pediatr. 1999;135:535–7.
Bartlett JG. Antibiotic-associated diarrhea. Clin Infect Dis. 1992;15:573–81.
Kelly CP, LaMont JT. Clostridium difficile infection. Annu Rev Med. 1998;49:375–90.
Anand A, Bashey B, Mir T, Glatt AE. Epidemiology, clinical manifestations, and outcome of Clostridium difficile-associated diarrhea. Am J Gastroenterol. 1994;89:519–23.
Al-Eidan FA, McElnay JC, Scott MG, Kearney MP. Clostridium difficile-associated diarrhea in hospitalized patients. J Clin Pharm Ther. 2000;25:101–9.
Gogate A, De A, Nanivadekar R, Mathur M, Saraswathi K, Jog A, et al. Diagnostic role of stool culture and toxin detection in antibiotic associated diarrhea due to Clostridium difficile in children. Indian J Med Res. 2005;122:518–24.
Johnson S, Gerding DN. Clostridium difficile-associated diarrhea. Clin Infect Dis. 1998;26:1027–34.
Johnston BC, Supina AL, Ospina M, Vohra S. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2007;18:CD004827
Avadhani A, Miley H. Probiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults. A meta-analysis. J Am Acad Nurse Pract. 2011;23:269–74.
Moubareck C, Gavini F, Vaugien L, Butel MJ, Doucet-Poupulaire F. Antimicrobial susceptibility of bifidobacteria. J Antimicrob Chemother. 2005;55:38–44.
Masco L, Van Hoorde K, De Brandt E, Swings J, Huys G. Antimicrobial susceptibility of Bifidobacterium strains from humans, animals and probiotic products. J Antimicrob Chemother. 2006;58:85–94.
Miller M. The fascination with probiotics for Clostridium difficile infection: lack of evidence for prophylactic or therapeutic efficacy. Anaerobe. 2009;15:281–4.
Musgrave CR, Bookstaver PB, Sutton SS, Miller AD. Use of alternative or adjuvant pharmacologic treatment strategies in the prevention and treatment of Clostridium difficile infection. Int J Infect Dis. 2011;15:e438–48.
Parkes GC, Sanderson JD, Whelan K. The mechanisms and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea. Lancet Infect Dis. 2009;9:237–44.
Clinical and Laboratory Standards Institute (CLSI). Methods for dilution antimicrobial susceptibility tests for bacterial that grow aerobically: approved standard. Eighth edition. CLSI document M07-A8. Wayne, PA: CLSI; 2009
Clinical and Laboratory Standards Institute (CLSI). Methods for antimicrobial susceptibility testing of anaerobic bacteria: approved standard. Seventh edition. CLSI document M11-A7. Wayne, PA: CLSI; 2007
Iwata S, Kawahara K, Isohata E, Kin Y, Yokota T, Kusumoto Y, et al. Effect of meropenem on fecal flora in children. Jpn J Antibiot. 1992;45:1385–402.
Iwata S, Yamamoto K, Isohata E, Kin Y, Yokota T, Kusumoto Y, et al. Effect of biapenem (L-627) on fecal flora in gnotobiotic mice and children. Jpn J Antibiot. 1994;47:1668–84.
Nakashima M, Uematsu T, Kanamaru M, Okazaki O, Hakusui H. Phase I study of levofloxacin, (s)-(−)-ofloxacin. Jpn J Clin Pharmacol Ther. 1992;23:515–20.
Nord CE, Brismar B, Kasholm-Tengve B, Tunevall G. Effect of piperacillin/tazobactam therapy on intestinal microflora. Scand J Infect Dis. 1992;24:209–13.
MotohiroT, Masunaga K, Ootu Y, Ikezawa S, Matsuo Y, Maruoka T, et al. Influence of tazobactam/piperacillin on human fecal flora. Chemotherapy 1994;42(suppl 2):300–317
Sekino H, Nakamichi N, Niida Y, Matsumoto S, Yokokawa M. Pharmacokinetic and tolerability study 600 mg of biapenem (BIPM) administered repeatedly. Kiso to Rinsho. 1996;30:3265–82.
Condon ER, Walker PA, Hanna BC, Greenberg NR, Broom A, Pitkin D. Penetration of meropenem in plasma and abdominal tissues from patients undergoing intraabdominal surgery. Clin Infect Dis. 1997;24(suppl 2):S181–3.
Edmiston CE, Krepel CJ, Seabrook GR, Towne JB, Smith TL, Loehrl TA, et al. Tissue and fluid penetration of garenoxacin in surgical patients. Surg Infect (Larchmt). 2007;8:179–88.
Neu HC. Third generation cephalosporins: safety profiles after 10 years of clinical use. J Clin Pharmacol. 1990;30:396–403.
Koizumi Y, Kimura T, Hatanaka S, Kadotani M, Takahashi Y. Risk factors for the induction of antibiotic-associated diarrhea. Jpn J Environ Infect. 2008;23:175–80.
Courvalin P. Antibiotic resistance: the pros and cons of probiotics. Dig Liver Dis. 2006;38(suppl 2):S261–5.
Werner G, Coque TM, Hammerum AM, Hope R, Hryniewicz W, Johnson A, et al. Emergence and spread of vancomycin resistance among enterococci in Europe. Euro Surveill 2008;13(47):19046
French GL. Enterococci and vancomycin resistance. Clin Infect Dis. 1998;27(suppl 1):S75–83.
Floch MH, Walker WA, Madsen K, Sanders ME, Macfarlane GT, Flint HJ, et al. Recommendations for probiotic use: 2011 update. J Clin Gastroenterol. 2011;45(suppl):S168–71.
Japan Medical Data Center. The information of precise estimates of the number of receiving drugs. http://www.jmdc.co.jp/en/srv_pharma/scene.html#souyaku. 2013.