{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:28:17Z","timestamp":1784514497202,"version":"3.55.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1200184"],"award-info":[{"award-number":["APP1200184"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Indian J Gastroenterol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In patients with primary sclerosing cholangitis (PSC), antimicrobial therapy with oral vancomycin (OV) is increasingly used to prevent progression of the liver disease and control concomitant ulcerative colitis (UC); however, there are concerns regarding the risk of development of vancomycin-resistant enterococci (VRE). Thus, we aimed to determine the incidence of VRE in PSC-UC patients.\u00a0We conducted a retrospective study of PSC-UC patients, treated with OV at the Department of Gastroenterology at the Princess Alexandra Hospital. VRE testing was performed utilizing rectal swabs.\u00a0We included 7 PSC-UC patients (age 22\u201353 years, 2 females) treated with OV with daily dose ranging from 250 to 1500 mg. All patients were treated for at least 6 months with OV (range 9\u201331 months, mean 32.1 months).\u00a0All patients achieved complete clinical remission of the UC, with mean reduction of fecal calprotectin by 634 \u03bcg\/mg (87.3%), mean reduction in the C-reactive protein by 21.9 mg\/L (74.2%), and mean reduction in the total Mayo score by 9.3 (93.3%). With regard to the liver parameters, mean improvement in alkaline phosphatase enzyme and total bilirubin was \u221248.7 U\/L (\u221219.7%) and \u22122.7 mg\/dL (\u221219.6%), respectively. No patient treated with OV developed VRE or reported any adverse events.\u00a0This cohort study including PSC-UC patients did not provide evidence for development of VRE, while treatment with vancomycin was associated with clinical and endoscopic remission of the UC. Larger, prospective trials are required to define the efficacy and safety of antimicrobial therapy in PSC-UC, while the risk of VRE appears small.<\/jats:p>","DOI":"10.1007\/s12664-022-01286-9","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T18:04:49Z","timestamp":1665425089000},"page":"519-524","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["How frequent are vancomycin-resistant enterococci in patients with primary sclerosing cholangitis and ulcerative colitis treated with oral vancomycin?"],"prefix":"10.1007","volume":"41","author":[{"given":"Ayesha","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Pakneeshan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Koloski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Callaghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Morrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-2358","authenticated-orcid":false,"given":"Gerald","family":"Holtmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"1286_CR1","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1038\/ajg.2015.112","volume":"110","author":"KD Lindor","year":"2015","unstructured":"Lindor KD, Kowdley KV, Harrison ME. ACG clinical guideline: primary sclerosing cholangitis. Am J Gastroenterol. 2015;110:646\u201359; quiz 660.","journal-title":"Am J Gastroenterol"},{"key":"1286_CR2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/s12664-019-00968-1","volume":"38","author":"P Tibdewal","year":"2019","unstructured":"Tibdewal P, Bhatt P, Jain A, Gupta D, Bhatia S, Shukla A. Clinical profile and outcome of primary sclerosing cholangitis: a single-centre experience from western India. Indian J Gastroenterol. 2019;38:295\u2013302.","journal-title":"Indian J Gastroenterol"},{"key":"1286_CR3","doi-asserted-by":"publisher","first-page":"814","DOI":"10.14309\/ajg.0000000000000604","volume":"115","author":"A Shah","year":"2020","unstructured":"Shah A, Macdonald GA, Morrison M, Holtmann G. Targeting the gut microbiome as a treatment for primary sclerosing cholangitis: a conceptional framework. Am J Gastroenterol. 2020;115:814\u201322.","journal-title":"Am J Gastroenterol"},{"key":"1286_CR4","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1055\/s-0039-1688501","volume":"39","author":"A Shah","year":"2019","unstructured":"Shah A, Crawford D, Burger D, et al. Effects of antibiotic therapy in primary sclerosing cholangitis with and without inflammatory bowel disease: a systematic review and meta-analysis. Semin Liver Dis. 2019;39:432\u201341.","journal-title":"Semin Liver Dis"},{"key":"1286_CR5","doi-asserted-by":"crossref","unstructured":"Dao A, Abidian M, Lestrange A, Mattar M, Rangnekar A, Charabaty A. Oral vancomycin induces and maintains remission of ulcerative colitis in the subset of patients with associated primary sclerosing cholangitis. Inflamm Bowel Dis. 2019;25:e90\u20131.","DOI":"10.1093\/ibd\/izz027"},{"key":"1286_CR6","doi-asserted-by":"crossref","unstructured":"Griffin PM, Price GR, Schooneveldt JM, et al. Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry to identify vancomycin-resistant enterococci and investigate the epidemiology of an outbreak. J Clin Microbiol. 2012;50:2918\u201331.","DOI":"10.1128\/JCM.01000-12"},{"key":"1286_CR7","doi-asserted-by":"crossref","unstructured":"Rankin JG, Boden RW, Goulston SJ, Morrow W. The liver in ulcerative colitis; treatment of pericholangitis with tetracycline. Lancet. 1959;2:1110\u20132.","DOI":"10.1016\/S0140-6736(59)90098-4"},{"key":"1286_CR8","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1097\/00005176-199811000-00015","volume":"27","author":"KL Cox","year":"1998","unstructured":"Cox KL, Cox KM. Oral vancomycin: treatment of primary sclerosing cholangitis in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 1998;27:580\u20133.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"1286_CR9","first-page":"10","volume":"24","author":"G Di Febo","year":"1992","unstructured":"Di Febo G, Calabrese C, Matassoni F. New trends in non-absorbable antibiotics in gastrointestinal disease. Ital J Gastroenterol. 1992;24:10\u20133.","journal-title":"Ital J Gastroenterol"},{"key":"1286_CR10","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1086\/502415","volume":"25","author":"CD Salgado","year":"2004","unstructured":"Salgado CD, Giannetta ET, Farr BM. Failure to develop vancomycin-resistant Enterococcus with oral vancomycin treatment of Clostridium difficile. Infect Control Hosp Epidemiol. 2004;25:413\u20137.","journal-title":"Infect Control Hosp Epidemiol"},{"key":"1286_CR11","doi-asserted-by":"crossref","unstructured":"Tan LZ, Reilly CR, Steward-Harrison LC, et al. Oral vancomycTan LZ, Reilly CR, Steward-Harrison LC, Balouch F, Muir R, Lewindon PJ.in induces clinical and mucosal remission of colitis in children with primary sclerosing cholangitis-ulcerative colitis. Gut. 2019;68:1533\u20135.","DOI":"10.1136\/gutjnl-2018-316599"}],"container-title":["Indian Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12664-022-01286-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12664-022-01286-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12664-022-01286-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T02:05:53Z","timestamp":1669946753000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12664-022-01286-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["1286"],"URL":"https:\/\/doi.org\/10.1007\/s12664-022-01286-9","relation":{},"ISSN":["0254-8860","0975-0711"],"issn-type":[{"value":"0254-8860","type":"print"},{"value":"0975-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]},"assertion":[{"value":"11 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Writing assistance"}},{"value":"Prof Gerald Holtmann","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor of the article"}},{"value":"GH reports to be on the advisory boards Australian Biotherapeutics, Glutagen, and Bayer, and received research support from Bayer, Abbott, Pfizer, Janssen, Takeda, and Allergan. He serves on the Boards of the West Moreton Hospital and Health Service, Queensland, UQ Healthcare, Brisbane, and the Gastro-Liga, Germany. He has a patent for the Brisbane aseptic biopsy device and serves as Editor of the Gastro-Liga Newsletter. MM serves on the scientific advisory board (honorary) for Genie Biome (Hong Kong) and received research support from Bayer and Soho Flordis International (SFI) Health. AS, SP, MPJ, NK, and GC\u00a0declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The author is solely responsible for the data and the contents of the paper. In no way is the honorary editor in chief, editorial board members, the Indian Society of Gastroenterology, or the printer\/publishers responsible for the results\/findings and content of this article Indian Journal of Gastroenterology.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}