Multi-drug Resistant Organisms

Multi-drug resistant organisms (MDROs) are bacteria that have become resistant to certain antibiotics. Like Clostridium difficile (C. diff.) infection, vancomycin-resistant Enterococcus (VRE) is a challenging healthcare acquired infection. VRE is a well-known complication among critically ill and immune compromised patients and is associated with increased mortality, length of hospital stay and costs.1-3

Both VRE and C. diff. are found in the intestinal tract and share similar risk factors including antibiotic use, contact with the healthcare system, and severe underlying illness. VRE positive patients also have been shown to have a greater prevalence of co-infection with multi-drug resistant organisms.

A secondary analysis of the PUNCH CD study found a high degree of VRE clearance concomitant with administration of RBX2660 for recurrent C. diff.5  More study is needed to confirm the hypothesis that a microbiota-based drug may provide a method of VRE clearance.


  1. Tavadze M, Rybicki L, Mossad S, et al. Risk factors for vancomycin-resistant enterococcus bacteremia and its influence on survival after allogenic hematopoietic cell transplantation. Bone Marrow Transplantation. 2014;49:1310-16.
  2. Jung E, Byun S, Lee H, Moon SI, Lee H. Vancomycin-resistant Enterococcus colonization in the intensive care unit: Clinical outcomes and attributable costs of hospitalization. Am J Infect Control. 2014;42:1062-6.
  3. Lloyd-Smith P, Younger J, Lloyd-Smith E, Green H, Leung V, Romney MG. Economic analysis of vancomycin-resistant enterococci at a Canadian hospital: Assessing attributable cost and length of stay. J Hosp Infect. 2013;85:54-9.
  4. Fujitani S, George WL, Morgan MA, Nichols S, Murthy AR. Implications for vancomycin-resistant Enterococcus colonization associated with Clostridium difficile infections. Am J Infect Control. 2011;39:188-93.
  5. Dubberke E, Jones C. Clearance of vancomycin-resistant Enterococcus concomitant with administration of a microbiota-based drug targeted at recurrent Clostridium difficile infection. Presented at ECCMID 2015. April 25-28, 2015, Copenhagen, Denmark.