Enterococcus Faecium: Evolution, Adaptation, Pathogenesis and Emerging Therapeutics

Overview

Journal Nat Rev Microbiol

Specialties Infectious Diseases
Microbiology

Date 2024 Jun 18

PMID 38890478

Authors

Yahan Wei

Dennise Palacios Araya

Kelli L Palmer

Affiliations

Soon will be listed here.

Abstract

The opportunistic pathogen Enterococcus faecium colonizes humans and a wide range of animals, endures numerous stresses, resists antibiotic treatment and stubbornly persists in clinical environments. The widespread application of antibiotics in hospitals and agriculture has contributed to the emergence of vancomycin-resistant E. faecium, which causes many hospital-acquired infections. In this Review, we explore recent discoveries about the evolutionary history, the environmental adaptation and the colonization and dissemination mechanisms of E. faecium and vancomycin-resistant E. faecium. These studies provide critical insights necessary for developing novel preventive and therapeutic approaches against vancomycin-resistant E. faecium and also reveal the intricate interrelationships between the environment, the microorganism and the host, providing knowledge that is broadly relevant to how antibiotic-resistant pathogens emerge and endure.

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References

Leclercq R, DERLOT E, Duval J, Courvalin P . Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988; 319(3):157-61. DOI: 10.1056/NEJM198807213190307. View

Frieden T, Munsiff S, Low D, Willey B, Williams G, FAUR Y . Emergence of vancomycin-resistant enterococci in New York City. Lancet. 1993; 342(8863):76-9. DOI: 10.1016/0140-6736(93)91285-t. View

Garcia-Solache M, Rice L . The Enterococcus: a Model of Adaptability to Its Environment. Clin Microbiol Rev. 2019; 32(2). PMC: 6431128. DOI: 10.1128/CMR.00058-18. View

Zhou X, Willems R, Friedrich A, Rossen J, Bathoorn E . Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics. Antimicrob Resist Infect Control. 2020; 9(1):130. PMC: 7418317. DOI: 10.1186/s13756-020-00770-1. View

Weiner-Lastinger L, Abner S, Edwards J, Kallen A, Karlsson M, Magill S . Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017. Infect Control Hosp Epidemiol. 2019; 41(1):1-18. PMC: 8276252. DOI: 10.1017/ice.2019.296. View

Panesso D, Reyes J, Rincon S, Diaz L, Galloway-Pena J, Zurita J . Molecular epidemiology of vancomycin-resistant Enterococcus faecium: a prospective, multicenter study in South American hospitals. J Clin Microbiol. 2010; 48(5):1562-9. PMC: 2863891. DOI: 10.1128/JCM.02526-09. View

Shrestha S, Kharel S, Homagain S, Aryal R, Mishra S . Prevalence of vancomycin-resistant enterococci in Asia-A systematic review and meta-analysis. J Clin Pharm Ther. 2021; 46(5):1226-1237. DOI: 10.1111/jcpt.13383. View

Alemayehu T, Hailemariam M . Prevalence of vancomycin-resistant enterococcus in Africa in one health approach: a systematic review and meta-analysis. Sci Rep. 2020; 10(1):20542. PMC: 7688635. DOI: 10.1038/s41598-020-77696-6. View

Contreras G, Munita J, Simar S, Luterbach C, Dinh A, Rydell K . Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I). Open Forum Infect Dis. 2022; 9(3):ofab616. PMC: 8830530. DOI: 10.1093/ofid/ofab616. View

10.

Hemapanpairoa J, Changpradub D, Thunyaharn S, Santimaleeworagun W . Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Infections. Antibiotics (Basel). 2021; 10(2). PMC: 7911214. DOI: 10.3390/antibiotics10020105. View

11.

Fox E, Ha D, Bounthavong M, Meng L, Mui E, Holubar M . Risk factors and outcomes associated with persistent vancomycin resistant Enterococcal Bacteremia. BMC Infect Dis. 2022; 22(1):855. PMC: 9670444. DOI: 10.1186/s12879-022-07864-8. View

12.

ODriscoll T, Crank C . Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management. Infect Drug Resist. 2015; 8:217-30. PMC: 4521680. DOI: 10.2147/IDR.S54125. View

13.

Joshi S, Shallal A, Zervos M . Vancomycin-Resistant Enterococci: Epidemiology, Infection Prevention, and Control. Infect Dis Clin North Am. 2021; 35(4):953-968. DOI: 10.1016/j.idc.2021.07.002. View

14.

Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet D . Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis. 2017; 18(3):318-327. DOI: 10.1016/S1473-3099(17)30753-3. View

15.

Mlaga K, Garcia V, Colson P, Ruimy R, Rolain J, Diene S . Extensive Comparative Genomic Analysis of and Reveals a Direct Association between the Absence of CRISPR-Cas Systems, the Presence of Anti-Endonuclease (ardA) and the Acquisition of Vancomycin Resistance in . Microorganisms. 2021; 9(6). PMC: 8224324. DOI: 10.3390/microorganisms9061118. View

16.

Pidot S, Gao W, Buultjens A, Monk I, Guerillot R, Carter G . Increasing tolerance of hospital to handwash alcohols. Sci Transl Med. 2018; 10(452). DOI: 10.1126/scitranslmed.aar6115. View

17.

Raven K, Reuter S, Reynolds R, Brodrick H, Russell J, Torok M . A decade of genomic history for healthcare-associated Enterococcus faecium in the United Kingdom and Ireland. Genome Res. 2016; 26(10):1388-1396. PMC: 5052055. DOI: 10.1101/gr.204024.116. View

18.

Rios R, Reyes J, Carvajal L, Rincon S, Panesso D, Echeverri A . Genomic Epidemiology of Vancomycin-Resistant Enterococcus faecium (VREfm) in Latin America: Revisiting The Global VRE Population Structure. Sci Rep. 2020; 10(1):5636. PMC: 7101424. DOI: 10.1038/s41598-020-62371-7. View

19.

Arias C, Murray B . The rise of the Enterococcus: beyond vancomycin resistance. Nat Rev Microbiol. 2012; 10(4):266-78. PMC: 3621121. DOI: 10.1038/nrmicro2761. View

20.

Lebreton F, Manson A, Saavedra J, Straub T, Earl A, Gilmore M . Tracing the Enterococci from Paleozoic Origins to the Hospital. Cell. 2017; 169(5):849-861.e13. PMC: 5499534. DOI: 10.1016/j.cell.2017.04.027. View