{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:07:00Z","timestamp":1790514420984,"version":"4.1.0"},"reference-count":16,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T00:00:00Z","timestamp":1467331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2016,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n The use of oral vancomycin or metronidazole for treatment of\n Clostridium difficile<\/jats:named-content>\n infection (CDI) may promote colonization by health care-associated pathogens due to disruption of the intestinal microbiota. Because the macrocyclic antibiotic fidaxomicin causes less alteration of the intestinal microbiota than vancomycin, we hypothesized that it would not lead to a loss of colonization resistance to vancomycin-resistant enterococci (VRE) and extended-spectrum-\u03b2-lactamase-producing\n Klebsiella pneumoniae<\/jats:named-content>\n (ESBL-Kp). Mice (8 per group) received orogastric saline, vancomycin, or fidaxomicin daily for 5 days at doses resulting in stool concentrations in mice similar to those measured in humans. The mice were challenged with 10\n 5<\/jats:sup>\n CFU of orogastric VRE or ESBL-Kp on day 2 of treatment and concentrations of the pathogens in stool were monitored. The impact of drug exposure on the microbiome was measured by cultures, real-time PCR for selected anaerobic bacteria, and deep sequencing. In comparison to saline controls, oral vancomycin promoted establishment of high-density colonization by VRE and ESBL-Kp in stool (8 to 10 log\n 10<\/jats:sub>\n CFU\/g;\n P<\/jats:italic>\n < 0.001), whereas fidaxomicin did not (<4 log\n 10<\/jats:sub>\n CFU;\n P<\/jats:italic>\n > 0.5). Vancomycin treatment resulted in significant reductions in enterococci,\n Bacteroides<\/jats:named-content>\n spp., and\n Clostridium leptum<\/jats:named-content>\n , whereas the population of aerobic and facultative Gram-negative bacilli increased; deep-sequencing analysis demonstrated suppression of\n Firmicutes<\/jats:named-content>\n and expansion of\n Proteobacteria<\/jats:named-content>\n during vancomycin treatment. Fidaxomicin did not cause significant alteration of the microbiota. In summary, in contrast to vancomycin, fidaxomicin treatment caused minimal disruption of the intestinal microbiota and did not render the microbiota susceptible to VRE and ESBL-Kp colonization.\n <\/jats:p>","DOI":"10.1128\/aac.02590-15","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T03:28:50Z","timestamp":1461036530000},"page":"3988-3993","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":39,"title":["Effect of Fidaxomicin versus Vancomycin on Susceptibility to Intestinal Colonization with Vancomycin-Resistant Enterococci and Klebsiella pneumoniae in Mice"],"prefix":"10.1128","volume":"60","author":[{"given":"Abhishek","family":"Deshpande","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Hurless","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Cadnum","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Chesnel","sequence":"additional","affiliation":[{"name":"Merck and Co., Inc., Kenilworth, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Gao","sequence":"additional","affiliation":[{"name":"Merck and Co., Inc., Kenilworth, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Chan","sequence":"additional","affiliation":[{"name":"Second Genome, Inc., San Bruno, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirisha","family":"Kundrapu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Polinkovsky","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Donskey","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"},{"name":"Geriatric Research, Education and Clinical Center, Cleveland VA Medical Center, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910812"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis338"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.042010-0"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00090-08"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/592710"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis440"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1086\/315428","article-title":"Effect of parenteral antibiotic administration on the establishment of colonization with vancomycin-resistant Enterococcus faecium in the mouse gastrointestinal tract","volume":"18","author":"Donskey CJ","year":"2000","unstructured":"Donskey CJ, Hanrahan JA, Hutton RA, Rice LB. 2000. Effect of parenteral antibiotic administration on the establishment of colonization with vancomycin-resistant Enterococcus faecium in the mouse gastrointestinal tract. J Infect Dis 18:1830\u20131833.","journal-title":"J Infect Dis"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.11.3610-3612.2003"},{"key":"e_1_3_2_10_2","volume-title":"CLSI document 32(3):M100-S20","author":"Clinical and Laboratory Standards Institute","year":"2012","unstructured":"Clinical and Laboratory Standards Institute. 2012. Performance standards for antimicrobial susceptibility testing. CLSI document 32(3):M100-S20. CLSI, Wayne, PA."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01045-07"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-363"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1086\/513755"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0609333103"},{"key":"e_1_3_2_15_2","volume-title":"Vegan: community ecology R package, version 2.0-10","author":"Jari O","year":"2013","unstructured":"Jari O, Guillaume B, Roeland K, Pierre L, Peter R, O'Hara R, Gavin L, Peter S, Henry H, Helene W. 2013. Vegan: community ecology R package, version 2.0-10. R Foundation for Statistical Computing, Vienna, Austria."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1586\/eri.13.46"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv256"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.02590-15","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.02590-15","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T20:34:04Z","timestamp":1645475644000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.02590-15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1128\/AAC.02590-15"],"URL":"https:\/\/doi.org\/10.1128\/aac.02590-15","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7]]},"assertion":[{"value":"2015-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}