[Source: PLoS One, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Vancomycin-resistance gene cluster, vanC, in the gut microbiome of acute leukemia patients undergoing intensive chemotherapy
Armin Rashidi , Zhigang Zhu, Thomas Kaiser, Dawn A. Manias, Shernan G. Holtan, Tauseef Ur Rehman, Daniel J. Weisdorf, Alexander Khoruts, Gary M. Dunny, Christopher Staley
Published: October 10, 2019 / DOI: https://doi.org/10.1371/journal.pone.0223890
Two recent reports suggested that the less common, less virulent enterococcal species, Enterococcus gallinarum and E. casseliflavus, with low-level vancomycin resistance due to chromosomally encoded vanC1 and vanC2/3, may influence host immunity. We reported that peri-transplant gut colonization with E. gallinarum and E. casseliflavus is associated with lower mortality after allogeneic hematopoietic cell transplantation (HCT). Because most acute leukemia patients undergoing HCT have received intensive chemotherapy (usually requiring prolonged hospitalization) for their underlying disease before HCT, we hypothesized that some may have acquired vanC-positive enterococci during chemotherapy. Therefore, we evaluated the presence of the vanC gene cluster using vanC1 and vanC2/3 qPCR in thrice-weekly collected stool samples from 20 acute leukemia patients undergoing intensive chemotherapy. We found that an unexpectedly large proportion of patients have detectable vanC1 and vanC2/3 (15% and 35%, respectively) in at least one stool sample. Comparing qPCR results with 16S rRNA gene sequencing results suggested that E. gallinarum may reach high abundances, potentially persisting into HCT and influencing transplant outcomes.
Citation: Rashidi A, Zhu Z, Kaiser T, Manias DA, Holtan SG, Rehman TU, et al. (2019) Vancomycin-resistance gene cluster, vanC, in the gut microbiome of acute leukemia patients undergoing intensive chemotherapy. PLoS ONE 14(10): e0223890. https://doi.org/10.1371/journal.pone.0223890
Editor: Senthilnathan Palaniyandi, University of Kentucky, UNITED STATES
Received: July 26, 2019; Accepted: October 1, 2019; Published: October 10, 2019
Copyright: © 2019 Rashidi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Raw sequencing data are deposited under accession number SRP141394 at the NCBI SRA.
Funding: This work was supported by grants from the University of Minnesota (Medical School Innovation award and Foundation grant for new faculty) to AR. In addition, funding from Achieving Cures Together and Hubbard Broadcasting Foundation supported this research. TK received partial support from the Masonic Cancer Center at the University of Minnesota. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Keywords: Antibiotics; Drugs Resistance; Vancomycin; Enterococci; Enterococcus gallinarum; Cancer; Leukemia.