Enterococcal autoprobiotics in the complex treatment of colorectal cancer patient receiving chemotherapy: Two case reports and review of literature

Table 1 Gastrointestinal Symptom Rating Scale results before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 47-year-old patient

Parameters/results, point	Abdominal pain	Reflux	Diarrhea	Dyspepsia	Constipation
Baseline (AP1)	1	1	4	3	1
Post-treatment (AP2)	0	0	1	1	0

AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.

Table 2 SF-36 quality of life questionnaire results before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 47-year-old patient

Parameters/results, point	Baseline (AP1)	Post-treatment (AP2)
Physical functioning	77	95
Role physical	48	86
Bodily pain	54	70
General health	49	63
Vitality	49	64
Social functioning	59	84
Role emotional	57	80
Mental health	57	68

AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.

Table 3 Results of real-time polymerase chain reaction for fecal microbiota composition before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 47-year-old patient

Parameters/results, point	Baseline (AP1)	Post-treatment (AP2)	Normal ranges
Total bacterial mass	3 × 1013	108	≤ 1012
Lactobacillus spp.	< 105	< 105	107-108
Bifidobacterium spp.	2 × 108	< 105	109-1010
Escherichia coli	2 × 109	108	107-108
Bacteroides spp.	3 × 1013	9 × 106	109-1012
Faecalibacterium prausnitzii	Not detected	2 × 106	108-1011
Bacteroides thetaomicron	Not detected	Not detected	≤ 1012
Akkermansia muciniphila	Not detected	Not detected	≤ 1011
Enterococcus spp.1	Not detected	Not detected	≤ 108
Escherichia coli enteropathogenic	Not detected	Not detected	≤ 104
Klebsiella pneumoniae	Not detected	Not detected	≤ 104
Klebsiella oxytoca	Not detected	Not detected	≤ 104
Candida spp.	Not detected	Not detected	≤ 104
Staphylococcus aureus	Not detected	Not detected	≤ 104
Clostridium difficile	Not detected	Not detected	Not detected
Clostridium perfringens	Not detected	Not detected	Not detected
Proteus vulgaris/mirabilis	1010	Not detected	≤ 104
Citrobacter spp.	Not detected	Not detected	≤ 104
Enterobacter spp.	8 × 108	Not detected	≤ 104
Fusobacterium nucleatum	Not detected	Not detected	Not detected
Parvimonas micra	Not detected	Not detected	Not detected
Salmonella spp.	Not detected	Not detected	Not detected
Shigella spp.	Not detected	Not detected	Not detected
Bacteroides fragilis group/Faecalibacterium prausnitzii ratio	> 100	4, 5	0.01-100

¹Absence of Enterococcus spp. may be explained not by the absence of these microorganisms in the feces, but by the limitation of the method, when the number of microorganisms less than 10³ is not detected. AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.

Table 4 Gastrointestinal Symptom Rating Scale results before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 54-year-old patient

Parameters/results, point	Abdominal pain	Reflux	Diarrhea	Dyspepsia	Constipation
Baseline (AP1)	2	1	3	4	0
Post-treatment (AP2)	0	0	0	1	1

AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.

Table 5 SF-36 quality of life questionnaire results before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 54-year-old patient

Parameters/results, point	Baseline (AP1)	Post-treatment (AP2)
Physical functioning	75	92
Role physical	51	84
Bodily pain	53	77
General health	52	68
Vitality	50	67
Social functioning	56	83
Role emotional	57	82
Mental health	55	73

AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.

Table 6 Results of real-time polymerase chain reaction for fecal microbiota composition before and after intake of indigenous non-pathogenic Enterococcus faecium strain in a colorectal cancer 54-year-old patient

Parameters/results, point	Baseline (AP1)	Post-treatment (AP2)	Normal ranges
Total bacterial mass	2 × 1012	7 × 1011	≤ 1012
Lactobacillus spp.	< 105	< 105	107-108
Bifidobacterium spp.	6 × 108	109	109-1010
Escherichia coli	2 × 108	108	107-108
Bacteroides spp.	2 × 1012	7 × 1011	109-1012
Faecalibacterium prausnitzii	109	3 × 109	108-1011
Bacteroides thetaomicron	109	3 × 105	≤ 1012
Akkermansia muciniphila	Not detected	Not detected	≤ 1011
Enterococcus spp.1	Not detected	Not detected	≤ 108
Escherichia coli enteropathogenic	Not detected	Not detected	≤ 104
Klebsiella pneumoniae	Not detected	Not detected	≤ 104
Klebsiella oxytoca	Not detected	Not detected	≤ 104
Candida spp.	Not detected	Not detected	≤ 104
Staphylococcus aureus	Not detected	Not detected	≤ 104
Clostridium difficile	Not detected	Not detected	Not detected
Clostridium perfringens	Not detected	Not detected	Not detected
Proteus vulgaris/mirabilis	Not detected	Not detected	≤ 104
Citrobacter spp.	Not detected	Not detected	≤ 104
Enterobacter spp.	7 × 105	Not detected	≤ 104
Fusobacterium nucleatum	Not detected	Not detected	Not detected
Parvimonas micra	Not detected	Not detected	Not detected
Salmonella spp.	Not detected	Not detected	Not detected
Shigella spp.	Not detected	Not detected	Not detected
Bacteroides fragilis group/Faecalibacterium prausnitzii ratio	2000	233	0.01-100

¹Absence of Enterococcus spp. may be explained not by the absence of these microorganisms in the feces, but by the limitation of the method, when the number of microorganisms less than 10³ is not detected. AP1: Scores before autoprobiotic therapy; AP2: Scores after autoprobiotic therapy.