Current Trends of Emergence and Spread of Vancomycin-Resistant Enterococci

Werner, Guido

doi:10.5772/29791

Cited by 184 publications

(261 citation statements)

References 347 publications

(389 reference statements)

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“…All of the strains with vanC to vanG genotypes were correctly identified as negative by the assay. Since genotypes vanE to vanG (and most probably the previously identified vanL and vanM, too; [Boyd et al, 2008] and [Xu et al, 2010]) still remain rare among clinical enterococcal isolates encountered in hospitals worldwide (Werner et al, 2008), this does not complicate substantially the performance and predictive value of the present assay in detecting and identifying VRE colonizers. Quite contrarily, the prevalence of vanB, vanD, vanE, and vanG genes among nonenterococcal, intestinal bacteria may thwart the good performance of a putative assay capable of detecting all acquired van genotypes ( [Domingo et al, 2005], [Domingo et al, 2007], [Graham et al, 2008], [Launay et al, 2006] and [Tsvetkova et al, 2010]).…”

Section: Discussionmentioning

confidence: 88%

“…In recent years, VRE prevalence rates increased in many European countries ( [Brown et al, 2008], [Henard et al, 2011], [Sagel et al, 2008], [Soderblom et al, 2010], [Theilacker et al, 2009] and [Werner et al, 2008]). This has led to increased interest in screening of patients for colonization as well as to increased interest in methods used for a fast, sensitive, and reliable VRE detection (Vonberg et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of direct cultivation on a selective solid medium, polymerase chain reaction from an enrichment broth, and the BD GeneOhm™ VanR Assay for identification of vancomycin-resistant enterococci in screening specimens

Werner

Serr

Schütt

et al. 2011

Diagnostic Microbiology and Infectious Disease

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Comparison of direct cultivation on a selective solid medium, polymerase chain reaction from an enrichment broth, and the BD GeneOhm™ VanR Assay for identification of vancomycin-resistant enterococci in screening specimens

Werner

Serr

Schütt

et al. 2011

Diagnostic Microbiology and Infectious Disease

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“…Acquired resistance, most prominently to penicilin/ampicillin, aminoglycosides (high-level resistance) and glycopeptides are reported in an increasing number of isolates and the therapeutic spectrum in these cases is limited. VRE is an important problem in Europe, and its prevalence is increasing by the years [23]. The VRE infections are reported in a high rate in Greece and Ireland however it is in a lower rate in Nordic countries.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Spectrum and Antimicrobial Susceptibility Pattern of Bloodstream Infections in Children with Febrile Neutropenia: Experience of Single Center in Southeast of Turkey

et al. 2011

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Empirical antimicrobial therapy is usually started in febrile neutropenic patients without having culture results. The aim of this study was to help determine the policies of empirical antibiotic usage in febrile neutropenic children by detecting the antimicrobial susceptibility profile in this group of patients. In this study 811 blood cultures taken from neutropenic children hospitalized at the Department of Oncology of Gaziantep Children Hospital November 2007 and February 2010 were retrospectively evaluated. Blood cultures were routinely collected in aerobic and anaerobic media and incubated using the BACTEC system. Identification and antimicrobial susceptibility testing of the isolates to antimicrobial agents was performed using the Vitek2 Ò system according to the recommendations of the Clinical and Laboratory Standards Institute. Of 811 isolates analyzed, 128 (56.4%) were gram positive cocci, 43 (18.9%) were gram negative bacilli and fungi accounted for 56 (24.7%). The main isolated Gram-positive bacteria from blood were coagulase-negative staphylococcus (56.7%), followed by methicillin-resistant Staphylococcus aureus (14.1%). S. aureus and Streptococcus spp. were all susceptible to linezolid, vancomycin and teicoplanin. S aureus was still susceptible to few other antimicrobial agents such as tetracycline (82.4%), chloramphenicol (55.6%). Seven E. faecium, 7 E. fecalis and 1 E. hirae was isolated from blood cultures. Vancomycin resistance was detected in 6 out of 15 (40%) Enterococcus spp. isolates. Among gram-negative bacteria E. coli (30.2%) was followed by Klebsiella pneumoniae (20.9%) and Proteus spp. (18.6%). Imipenem (89.2%), meropenem (86.6%), chloramphenicol (88.9%), amicasin (82.4%) and fosfomycin (81.3%) showed highest susceptibility in vitro activity against all Gram-negative isolates. To know the antimicrobial susceptibility profile of the pathogens frequently isolated from febrile neutropenic children and to consider this profile before starting an empirical antibiotic therapy would help the clinics which have any role in the treatment of these patients to determine the empirical antibiotic usage policies.

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“…This complex is characterized by ampicillin and quinolones resistance and by the presence of a putative pathogenicity island. Currently, the increase in E. faecium resistant to ampicillin usually precedes increasing rates of VREfm in various locations around the world, especially in certain European countries, where until recently, VRE rates were low 4,[23][24][25][26] . In the USA, since the 1990s, E. faecium isolates account for more than 95% of all VRE recovered and most of them are also resistant to ampicillin 24 .…”

Section: Conflict Of Interest Financial Support Referencesmentioning

confidence: 99%

Trends in antimicrobial resistance among clinical isolates of enterococci in a Brazilian tertiary hospital: a 4-year study

Conceição

Oliveira

Silva

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: In the past two decades members of the genus Enterococcus have emerged as important nosocomial pathogens worldwide. This study prospectively analyzed the distribution of species and trends in antimicrobial resistance among clinical isolates of enterococci in a Brazilian tertiary hospital from 2006-2009. Methods: Enterococcal species were identified by conventional biochemical tests. The antimicrobial susceptibility profile was performed by disk diffusion in accordance with the Clinical and Laboratory Standards Institute (CLSI). A screening test for vancomycin was also performed. Minimal inhibitory concentration (MIC) for vancomycin was determined using the broth dilution method. Molecular assays were used to confirm speciation and genotype of vancomycin-resistant enterococci (VRE). Results: A total of 324 non-repetitive enterococcal isolates were recovered, of which 87% were E. faecalis and 10.8% E. faecium. The incidence of E. faecium per 1,000 admissions increased significantly (p < 0.001) from 0.3 in 2006 to 2.3 in 2009. The VRE rate also increased over time from 2.5% to 15.5% (p < 0.001). All VRE expressed high-level resistance to vancomycin (MIC >256μg/ mL) and harbored vanA genes. The majority (89.5%) of VRE belonged to E. faecium species, which were characteristically resistant to ampicillin and quinolones. Overall, ampicillin resistance rate increased significantly from 2.5% to 21.4% from 2006-2009. Resistance rates for gentamicin, chloramphenicol, tetracycline, and erythromycin significantly decreased over time, although they remained high. Quinolones resistance rates were high and did not change significantly over time. Conclusions: The data obtained show a significant increasing trend in the incidence of E. faecium resistant to ampicillin and vancomycin.

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Current Trends of Emergence and Spread of Vancomycin-Resistant Enterococci

Cited by 184 publications

References 347 publications

Comparison of direct cultivation on a selective solid medium, polymerase chain reaction from an enrichment broth, and the BD GeneOhm™ VanR Assay for identification of vancomycin-resistant enterococci in screening specimens

Comparison of direct cultivation on a selective solid medium, polymerase chain reaction from an enrichment broth, and the BD GeneOhm™ VanR Assay for identification of vancomycin-resistant enterococci in screening specimens

Bacterial Spectrum and Antimicrobial Susceptibility Pattern of Bloodstream Infections in Children with Febrile Neutropenia: Experience of Single Center in Southeast of Turkey

Trends in antimicrobial resistance among clinical isolates of enterococci in a Brazilian tertiary hospital: a 4-year study

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