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Original Article
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Volume 345:1161-1166 October 18, 2001 Number 16
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Transient Intestinal Carriage after Ingestion of Antibiotic-Resistant Enterococcus faecium from Chicken and Pork
Thomas Lund Sørensen, M.D., Marianne Blom, M.Sc., Dominique L. Monnet, Ph.D., Niels Frimodt-Møller, M.D., D.M.Sc., Rikke Lykke Poulsen, Ph.D., and Frank Espersen, M.D., D.M.Sc.

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ABSTRACT

Background Antibiotic-resistant enterococci are often present in retail meats, but it is unclear whether the ingestion of these contaminants leads to sustained intestinal carriage.

Methods We conducted a randomized, double-blind study in 18 healthy volunteers. Six ingested a mixture of 107 colony-forming units (CFU) of two glycopeptide-resistant strains of Enterococcus faecium obtained from chicken purchased at a grocery store, six ingested 107 CFU of a streptogramin-resistant strain of E. faecium obtained from a pig at slaughter, and six ingested 107 CFU of a glycopeptide-susceptible and streptogramin-susceptible strain of E. faecium from chicken purchased at a grocery store. Suspensions of enterococci were prepared in 250 ml of whole milk and were well within the amounts deemed acceptable by Danish food regulations. Stool samples were collected before exposure, daily for 1 week after ingestion, and at 14 and 35 days. Resistant enterococci in stools were identified by selective culture techniques; further molecular characterization of the organisms was also conducted.

Results At the outset, none of the subjects were colonized with glycopeptide-resistant or streptogramin-resistant E. faecium. After ingestion of the study strains, these same strains were isolated from the stools of all subjects, in various concentrations. The test strain was isolated in stool from 8 of 12 subjects on day 6, and from 1 of 12 on day 14. All stool samples were negative at 35 days.

Conclusions The ingestion of resistant E. faecium of animal origin leads to detectable concentrations of the resistant strain in stools for up to 14 days after ingestion. The organisms survive gastric passage and multiply.


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From the Department of Microbiological Research and Development, Statens Serum Institut, Copenhagen, Denmark.

Address reprint requests to Dr. Frimodt-Møller at Antimicrobial Resistance Surveillance, Department of Microbiological Research and Development, Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen S, Denmark, or at nfm{at}ssi.dk.

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