Last Bacteria Standing: VREfm Persistence in the Hospitalized Gut

Abstract

Enterococci are gram-positive, gastrointestinal (GI) tract commensal bacteria that have recently evolved into multidrug-resistant nosocomial pathogens. Enterococci are intrinsically hardy, meaning that they can thrive in challenging environments and outlast other commensal bacteria.

Bacteriocin production facilitates nosocomial emergence of vancomycin-resistantEnterococcus faecium

“…Hospitalized patients are often exposed to high levels of antibiotics, which decrease the diversity of commensals in the GI tract and facilitate the overgrowth of multidrug-resistant organisms like vancomycin-resistant E. faecium (VREfm) [2][3][4] . VREfm overgrowth within the intestinal tract predisposes patients to invasive bloodstream infections 2,[4][5][6][7] . Further, increased VREfm GI tract burdens cause patients to shed VREfm into the environment, facilitating transmission to other patients mainly through the fecal-oral route [8][9][10] .…”