Vancomycin dependent Enterococcus: an unusual mutant?

Sukumaran, Vichitra; Cosh, Jacqueline; Thammavong, Aline; Kennedy, Karina; Ong, Chong Wei

doi:10.1016/j.pathol.2018.11.012

Cited by 6 publications

(6 citation statements)

References 10 publications

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“…48 The advent of vancomycin-resistant enterococci (VRE) infections and the emergence of vancomycin-dependent enterococcus illustrate the concept of ecological impact from antibacterial usage. 49 Enterococci are commensal bacteria within the gastrointestinal tract-and the increasing usage of vancomycin in the latter part of the 20th century has led to increased rates of VRE, via mutations from antibiotic selection pressures and horizontal transmission between patients. 50 As a result, outbreaks of infections from VRE followed, affecting those who may not have been colonized with VRE on admission as well as those who did not receive antibacterials.…”

Section: The Risks Of Antibacterial Usage Are Limited To Patients Rec...mentioning

confidence: 99%

Ten common misconceptions about antibiotic use in the hospital

Lam,

Bourassa‐Blanchette

2023

Journal of Hospital Medicine

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Antimicrobials are one of the most administered medications in hospitals. Thoughtful and rational antibiotic prescribing by clinicians are important in reducing the adverse effects to both the host that takes the antibiotic and also the individuals in the host's community. Principles informing antibiotic prescribing in the hospital are commonly rooted in misconceptions. We review 10 common myths associated with antibacterial usage in hospitalized patients and share contemporary evidence in hopes of enhancing evidence‐informed practice in this patient care setting.

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Section: The Risks Of Antibacterial Usage Are Limited To Patients Rec...mentioning

confidence: 99%

Ten common misconceptions about antibiotic use in the hospital

Lam,

Bourassa‐Blanchette

2023

Journal of Hospital Medicine

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“…Such dependent strains are not considered primary pathogens and are isolated as result of the microbiological surveillance in these patients. Examples of this include an enterococci isolated from a patient receiving vancomycin to treat a sepsis caused by a coagulase-negative Staphylococcus , E. faecium from the faces of a patient receiving vancomycin to treat methicillin/oxacillin-resistant S. aureus and an E. faecium isolated from a female patient on intravenous vancomycin therapy for multiple traumatic injuries [ 71 , 75 , 82 ]. In these cases, the pathogenic potential of the strains is not established [ 92 ].…”

Section: Clinical Implications Of Antibiotic Dependencementioning

confidence: 99%

Fierce poison to others: the phenomenon of bacterial dependence on antibiotics

2023

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Beyond the development of resistance, the effects of antibiotics on bacteria and microbial communities are complex and far from exhaustively studied. In the context of the current global antimicrobial resistance crisis, understanding the adaptive and physiological responses of bacteria to antimicrobials is of paramount importance along with the development of new therapies. Bacterial dependence on antibiotics is a phenomenon in which antimicrobials instead of eliminating the pathogens actually provide a boost for their growth. This trait comprises an extreme example of the complexities of responses elicited by microorganisms to these drugs. This compelling evolutionary trait was readily described along with the first wave of antibiotics use and dependence to various antimicrobials has been reported. Nevertheless, current molecular characterizations have been focused on dependence on vancomycin, linezolid and colistin, three critically important antibiotics frequently used as last resource therapy for multi resistant pathogens. Outstanding advances have been made in understanding the molecular basis for the dependence to vancomycin, including specific mutations involved. Regarding linezolid and colistin, the general physiological components affected by the dependence, namely ribosomes and membrane function respectively, have been established. Nonetheless the implications of antibiotic dependence in clinically relevant features, such as virulence, epidemics, relationship with development of resistance, diagnostics and therapy effectiveness require clarification. This review presents a brief introduction of the phenomenon of bacterial dependence to antibiotics and a summary on early and current research concerning the basis for this trait. Furthermore, the available information on the effect of dependence in key clinical aspects is discussed. The studies performed so far underline the need to fully disclose the biological and clinical significance of this trait in pathogens to successfully assess its role in resistance and to design adjusted therapies.

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“…Unfortunately, suspension of vancomycin treatment may be insufficient to cure VDE infections due to the rapid reversion of VDE to vancomycin-independent colonies in vitro [ 440 ], likely through further mutations that allow re-activation of D-Ala-D-Ala synthesis or constitutive activation of an alternative van pathway [ 82 ]. Although rare, VDE infections in human patients have been reported in the literature [ 439 , 440 , 441 , 443 , 444 , 445 , 446 , 447 , 448 ]. However, due to the infrequent nature of such infections, VDE are poorly studied and understood, while optimum treatment guidelines remain unclear [ 445 ].…”

Section: Vancomycinmentioning

confidence: 99%

“…Although rare, VDE infections in human patients have been reported in the literature [ 439 , 440 , 441 , 443 , 444 , 445 , 446 , 447 , 448 ]. However, due to the infrequent nature of such infections, VDE are poorly studied and understood, while optimum treatment guidelines remain unclear [ 445 ].…”

Section: Vancomycinmentioning

confidence: 99%

Vancomycin Resistance in Enterococcus and Staphylococcus aureus

Walker

Oliveira

2022

Microorganisms

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Enterococcus faecalis, Enterococcus faecium and Staphylococcus aureus are both common commensals and major opportunistic human pathogens. In recent decades, these bacteria have acquired broad resistance to several major classes of antibiotics, including commonly employed glycopeptides. Exemplified by resistance to vancomycin, glycopeptide resistance is mediated through intrinsic gene mutations, and/or transferrable van resistance gene cassette-carrying mobile genetic elements. Here, this review will discuss the epidemiology of vancomycin-resistant Enterococcus and S. aureus in healthcare, community, and agricultural settings, explore vancomycin resistance in the context of van and non-van mediated resistance development and provide insights into alternative therapeutic approaches aimed at treating drug-resistant Enterococcus and S. aureus infections.

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Vancomycin dependent Enterococcus: an unusual mutant?

Cited by 6 publications

References 10 publications

Ten common misconceptions about antibiotic use in the hospital

Ten common misconceptions about antibiotic use in the hospital

Fierce poison to others: the phenomenon of bacterial dependence on antibiotics

Vancomycin Resistance in Enterococcus and Staphylococcus aureus

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