Working with mice and human patients, Eric Pamer, Carles Ubdea, and colleagues, at Memorial Sloan-Kettering Cancer Center, New York, have generated data that suggest that high-throughput DNA sequencing of bacteria in the gut could identify patients at high-risk of life-threatening bloodstream infection with the antibiotic-resistant bacterium vancomycin-resistant Enterococcus (VRE).
Bacterial infections acquired as a result of treatment in a hospital or health-care unit kill approximately 100,000 people a year in the US. Many of these lethal infections are caused by antibiotic-resistant bacteria such as VRE. Fatal VRE infections occur when VRE leaves the gut and invades the bloodstream.
Although patients with a compromised immune system are most at risk of these infections, not all become infected. It would therefore be useful to develop ways to identify more precisely those at greatest risk.
In the study, high-throughput DNA sequencing of bacteria in the gut (a process done by analyzing the feces) confirmed previous studies that antibiotic treatment dramatically disturbs the pattern of bacteria present.
Of immense potential clinical value was the observation that subsequent colonization of the gut predominantly with Enterococcal bacteria preceded bloodstream invasion with VRE.
Thus, as the authors and, in an accompanying commentary, Colby Zaph, at the University of British Columbia, Vancouver, suggest, monitoring fecal bacteria content could identify patients at high risk of bloodstream infection with VRE and provide a window for therapeutic intervention.
Source: Karen Honey
Journal of Clinical Investigation