Vancomycin-resistant enterococci

Uttley, A.H.C.; Woodford, N; Johnson, Alan P.; Cookson, Barry; George, Robert C.; Wilcox, M. H.; Spencer, R. C.; Weeks, G.R.; Frieden, T.R.; Munsiff, SonalS; Low, DonaldE; Kreiswirth, Barry N; Manso, Esther; Sio, Giuseppina De; Biavasco, Francesca; Varaldo, PietroE; Sambo, G; Maffei, C.

doi:10.1016/0140-6736(93)91440-w

Cited by 95 publications

(93 citation statements)

References 16 publications

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“…Our data confirm that ampicillin resistance preceded the emergence of vancomycin resistance within the CC17 genogroup in the United States, as has been shown in European studies [15, 37]. The earliest known vancomycin resistant E. faecium strain was isolated in Europe in 1986 [38, 39]. Among our isolates, vancomycin resistance ( P = 0.044 for CC17 versus non-CC17) first appeared among CC17 genogroup isolates in 1990 by acquiring the vanA gene cluster.…”

Section: Discussionsupporting

confidence: 87%

Analysis of Clonality and Antibiotic Resistance among Early Clinical Isolates ofEnterococcus faeciumin the United States

et al. 2009

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Background The Enterococcus faecium genogroup, referred to as clonal complex 17 (CC17), seems to possess multiple determinants that increase its ability to survive and cause disease in nosocomial environments. Methods Using 53 clinical and geographically diverse US E. faecium isolates dating from 1971 to 1994 we determined the multi-locus sequence type, the presence of 16 putative virulence genes (hylEfm, espEfm and fms genes), resistance to ampicillin (AMPR), vancomycin (VANR) and high-levels of gentamicin and streptomycin. Results Overall, 16 different sequence types (STs), mostly CC17 isolates, were identified in 9 different regions of the US. The earliest CC17 isolates were part of an outbreak in 1982 in Richmond, VA. Characteristics of CC17 isolates included increases in AMPR, the presence of hylEfm and espEfm, emergence of VANR and the presence of at least 13/14 fms genes. Eight out of forty-one of the early AMPR isolates, however, were not within CC17. Conclusions While not all early US AMPR isolates were clonally related, E. faecium CC17 isolates have been circulating in the US since at least 1982 and appear to have progressively acquired additional virulence and antibiotic resistance determinants, perhaps explaining the recent success of this species in the hospital environment.

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Section: Discussionsupporting

confidence: 87%

Analysis of Clonality and Antibiotic Resistance among Early Clinical Isolates ofEnterococcus faeciumin the United States

et al. 2009

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“…In the middle to late 1970s, enterococci began to be isolated as common causes of hospital-acquired infections [1, 5] for reasons that are not totally clear [5], but probably related to the expanding use of the antibiotics to which enterococci are naturally resistant [1, 10]. In 1986, the first vancomycin-resistant Enterococcus (VRE) strain was isolated in the United Kingdom [14, 15]. Since then, enterococci have emerged as the leading causes of nosocomial infections, ranking as the second-most frequent cause of urinary tract and wound infections, and the third-most frequent cause of bacteremia in the United States [1, 5].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the tertiary structure of the peptidoglycan of Enterococcus faecalis

Yang

Singh

Kim

et al. 2017

Biochimica et Biophysica Acta (BBA) - Biomembranes

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Solid-state NMR spectra of whole cells and isolated cell walls of Enterococcus faecalis grown in media containing combinations of 13C and 15N specific labels in D- and L-alanine and L-lysine (in the presence of an alanine racemase inhibitor alaphosphin) have been used to determine the composition and architecture of the cell-wall peptidoglycan. The compositional variables include the concentrations of (i) peptidoglycan stems without bridges, (ii) D-alanylated wall teichoic acid, (iii) cross-links, and (iv) uncross-linked tripeptide and tetra/pentapeptide stems. Connectivities of L-alanyl carbonyl-carbon bridge labels to D-[3-13C]alanyl and L-[ε-15N] lysyl stem labels prove that the peptidoglycan of E. faecalis has the same hybrid short-bridge architecture (with a mix of parallel and perpendicular stems) as the FemA mutant of Staphylococcus aureus, in which the cross-linked stems are perpendicular to one another and the cross-linking is close to the ideal 50% value. This is the first determination of the cell-wall chemical and geometrical architecture of whole cells of E. faecalis, a major source of nosocomial infections worldwide.

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“…In 1988, the first cases of vancomycin resistant Enterococcus faecalis and Enterococcus faecium (MICs ≥32 µg/mL) were reported from England,31 32 France,33 Germany,34 and the USA 35 36. In 1993, almost 14% of enterococci isolated from intensive care units (ICU) in the USA were resistant to vancomycin 37.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: literature review and options for treatment

et al. 2015

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Background Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or resistance is an important clinical issue worldwide. Purpose To review the published literature on endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance. Methods The data were analysed from a PubMed search of endophthalmitis cases caused by Gram-positive organisms with reported reduced vancomycin susceptibility and/or vancomycin resistance from 1990 to 2015. Results From 18 publications identified, a total of 27 endophthalmitis cases caused by Gram-positive organisms with reduced vancomycin susceptibility and/or vancomycin resistance were identified. The aetiologies of endophthalmitis were exogenous in 19/27 cases (11 post-cataract surgery, 2 post-penetrating keratoplasty, 1 post-glaucoma surgery, 4 post-open globe injury, 1 post-intravitreal injection of ranibizumab), and endogenous in 4/24 cases; no details were available about the four remaining patients. The causative organisms included Enterococcus species (7/27), coagulase-negative staphylococci (4/27), Staphylococcus aureus (4/27), Bacillus species (4/27), Streptococcus species (3/27), Leuconostoc species (3/27), Staphylococcus hominis (1/27), and unidentified Gram-positive cocci (1/27). Visual acuity of 20/400 or better at the final follow-up was recorded in 10/26 patients (38.5%; data were not available for one patient). Treatment options include fluoroquinolones, penicillin, cephalosporins, tetracyclines, and oxazolidinones. Conclusions In the current study, visual acuity outcomes were generally poor. Enterococcus and Staphylococcus species were the most common organisms reported and postoperative endophthalmitis after cataract surgery was the most common clinical setting.

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Vancomycin-resistant enterococci

Cited by 95 publications

References 16 publications

Analysis of Clonality and Antibiotic Resistance among Early Clinical Isolates ofEnterococcus faeciumin the United States

Analysis of Clonality and Antibiotic Resistance among Early Clinical Isolates ofEnterococcus faeciumin the United States

Characterization of the tertiary structure of the peptidoglycan of Enterococcus faecalis

Endophthalmitis caused by Gram-positive organisms with reduced vancomycin susceptibility: literature review and options for treatment

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