Suppression of gastric acid production by proton pump inhibitor treatment facilitates colonization of the large intestine by vancomycin-resistant Enterococcus spp. and Klebsiella pneumoniae in clindamycin-treated mice

Abstract

Proton pump inhibitor treatment of clindamycin-treated mice elevated the gastric pH and facilitated the establishment of colonization of the large intestine by vancomycin-resistant Enterococcus spp. (75 to 80%, versus 20 to 25% for saline-treated controls) and Klebsiella pneumoniae (90%, versus 30% for saline-treated controls). These findings demonstrate a mechanism by which proton pump inhibitor therapy could contribute to the dissemination of nosocomial pathogens.

FIG. 1.

Establishment of colonization of the large intestine after esophageal inoculation of 100 CFU of vancomycin-resistant enterococci (A and B) and extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (C) in mice receiving pantoprazole treatment versus establishment of colonization in controls receiving saline. Data for individual mice and mean values (horizontal lines) are shown.