Vancomycin-resistant Enterococci

Overview

Journal Clin Microbiol Rev

Publisher American Society for Microbiology

Specialty Microbiology

Date 2000 Oct 12

PMID 11023964

Citations 322

Authors

Y Cetinkaya

P Falk

C G Mayhall

Affiliations

Soon will be listed here.

Abstract

After they were first identified in the mid-1980s, vancomycin-resistant enterococci (VRE) spread rapidly and became a major problem in many institutions both in Europe and the United States. Since VRE have intrinsic resistance to most of the commonly used antibiotics and the ability to acquire resistance to most of the current available antibiotics, either by mutation or by receipt of foreign genetic material, they have a selective advantage over other microorganisms in the intestinal flora and pose a major therapeutic challenge. The possibility of transfer of vancomycin resistance genes to other gram-positive organisms raises significant concerns about the emergence of vancomycin-resistant Staphylococcus aureus. We review VRE, including their history, mechanisms of resistance, epidemiology, control measures, and treatment.

Citing Articles

Discovery of amino acid substitutions in penicillin-binding proteins associated with adaptation to D-Ala-D-Lac in vancomycin-resistant .

Caglayan N, Sancak B, Kanlidere Z, Kocagoz T Front Cell Infect Microbiol. 2025; 15:1522114.

PMID: 40007607 PMC: 11850342. DOI: 10.3389/fcimb.2025.1522114.

Electrochemical aptasensor for the selective detection of vancomycin based on nanostructured "in-lab" printed electrodes.

Bibani M, Casian M, Feier B, Bogdan D, Hosu-Stancioiu O, Ktari N Mikrochim Acta. 2025; 192(2):107.

PMID: 39863729 PMC: 11762413. DOI: 10.1007/s00604-025-06952-1.

Using electronic medical records in hospital simulation for infection control intervention assessment.

Haghpanah F, Klein E Infect Control Hosp Epidemiol. 2025; :1-7.

PMID: 39783122 PMC: 11883657. DOI: 10.1017/ice.2024.224.

Dynamic collateral sensitivity profiles highlight opportunities and challenges for optimizing antibiotic treatments.

Maltas J, Huynh A, Wood K PLoS Biol. 2025; 23(1):e3002970.

PMID: 39774800 PMC: 11709278. DOI: 10.1371/journal.pbio.3002970.

Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017-2022.

Lee S, Nam J, Kim J, Kim S, Yoo J Antibiotics (Basel). 2025; 13(12.

PMID: 39766600 PMC: 11672432. DOI: 10.3390/antibiotics13121210.

References

Bostic G, Perri M, Thal L, Zervos M . Comparative in vitro and bactericidal activity of oxazolidinone antibiotics against multidrug-resistant enterococci. Diagn Microbiol Infect Dis. 1998; 30(2):109-12. DOI: 10.1016/s0732-8893(97)00210-1. View

Montecalvo M, de Lencastre H, Carraher M, Gedris C, Chung M, VanHorn K . Natural history of colonization with vancomycin-resistant Enterococcus faecium. Infect Control Hosp Epidemiol. 1995; 16(12):680-5. DOI: 10.1086/647041. View

Clark N, Cooksey R, Hill B, Swenson J, Tenover F . Characterization of glycopeptide-resistant enterococci from U.S. hospitals. Antimicrob Agents Chemother. 1993; 37(11):2311-7. PMC: 192384. DOI: 10.1128/AAC.37.11.2311. View

Arthur M, Depardieu F, Molinas C, Reynolds P, Courvalin P . The vanZ gene of Tn1546 from Enterococcus faecium BM4147 confers resistance to teicoplanin. Gene. 1995; 154(1):87-92. DOI: 10.1016/0378-1119(94)00851-i. View

Zaman M, Landman D, Burney S, Quale J . Treatment of experimental endocarditis due to multidrug-resistant Enterococcus faecium with clinafloxacin and penicillin. J Antimicrob Chemother. 1996; 37(1):127-32. DOI: 10.1093/jac/37.1.127. View

Poyart C, Pierre C, Quesne G, Pron B, Berche P, Trieu-Cuot P . Emergence of vancomycin resistance in the genus Streptococcus: characterization of a vanB transferable determinant in Streptococcus bovis. Antimicrob Agents Chemother. 1997; 41(1):24-9. PMC: 163654. DOI: 10.1128/AAC.41.1.24. View

Felmingham D . Towards the ideal glycopeptide. J Antimicrob Chemother. 1993; 32(5):663-6. DOI: 10.1093/jac/32.5.663. View

Gordon S, Swenson J, Hill B, Pigott N, Facklam R, Cooksey R . Antimicrobial susceptibility patterns of common and unusual species of enterococci causing infections in the United States. Enterococcal Study Group. J Clin Microbiol. 1992; 30(9):2373-8. PMC: 265508. DOI: 10.1128/jcm.30.9.2373-2378.1992. View

Tally F, Ellestad G, Testa R . Glycylcyclines: a new generation of tetracyclines. J Antimicrob Chemother. 1995; 35(4):449-52. DOI: 10.1093/jac/35.4.449. View

10.

Schaberg D, Culver D, Gaynes R . Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991; 91(3B):72S-75S. DOI: 10.1016/0002-9343(91)90346-y. View

11.

Arthur M, Depardieu F, Gerbaud G, Galimand M, Leclercq R, Courvalin P . The VanS sensor negatively controls VanR-mediated transcriptional activation of glycopeptide resistance genes of Tn1546 and related elements in the absence of induction. J Bacteriol. 1997; 179(1):97-106. PMC: 178666. DOI: 10.1128/jb.179.1.97-106.1997. View

12.

Wu Z, Wright G, WALSH C . Overexpression, purification, and characterization of VanX, a D-, D-dipeptidase which is essential for vancomycin resistance in Enterococcus faecium BM4147. Biochemistry. 1995; 34(8):2455-63. DOI: 10.1021/bi00008a008. View

13.

Fontana R, Grossato A, Rossi L, Cheng Y, Satta G . Transition from resistance to hypersusceptibility to beta-lactam antibiotics associated with loss of a low-affinity penicillin-binding protein in a Streptococcus faecium mutant highly resistant to penicillin. Antimicrob Agents Chemother. 1985; 28(5):678-83. PMC: 176356. DOI: 10.1128/AAC.28.5.678. View

14.

Chow J, Davidson A, Sanford 3rd E, Zervos M . Superinfection with Enterococcus faecalis during quinupristin/dalfopristin therapy. Clin Infect Dis. 1997; 24(1):91-2. DOI: 10.1093/clinids/24.1.91. View

15.

Ingerman M, Santoro J . Vancomycin. A new old agent. Infect Dis Clin North Am. 1989; 3(3):641-51. View

16.

Quale J, Landman D, Saurina G, Atwood E, Ditore V, Patel K . Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci. Clin Infect Dis. 1996; 23(5):1020-5. DOI: 10.1093/clinids/23.5.1020. View

17.

Tornieporth N, Roberts R, John J, Hafner A, Riley L . Risk factors associated with vancomycin-resistant Enterococcus faecium infection or colonization in 145 matched case patients and control patients. Clin Infect Dis. 1996; 23(4):767-72. DOI: 10.1093/clinids/23.4.767. View

18.

Quintiliani Jr R, Evers S, Courvalin P . The vanB gene confers various levels of self-transferable resistance to vancomycin in enterococci. J Infect Dis. 1993; 167(5):1220-3. DOI: 10.1093/infdis/167.5.1220. View

19.

Swenson J, Clark N, Ferraro M, Sahm D, Doern G, Pfaller M . Development of a standardized screening method for detection of vancomycin-resistant enterococci. J Clin Microbiol. 1994; 32(7):1700-4. PMC: 263767. DOI: 10.1128/jcm.32.7.1700-1704.1994. View

20.

Dever L, Smith S, Handwerger S, Eng R . Vancomycin-dependent Enterococcus faecium isolated from stool following oral vancomycin therapy. J Clin Microbiol. 1995; 33(10):2770-3. PMC: 228574. DOI: 10.1128/jcm.33.10.2770-2773.1995. View