Vancomycin-resistente Enterokokken (VRE)

Klare, Ingo; Witte, Wolfgang; Wendt, Constanze; Werner, Guido

doi:10.1007/s00103-012-1564-6

Cited by 34 publications

(11 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical E. faecium strains are able to acquire the vanB transposon, and gain resistance to vancomycin at a minimal fitness cost [ 84 ]. The recent, and largely unexplained, increase of vanB- positive E. faecium strains in Europe [ 85 , 86 ] may possibly be caused by a further spread of vanB -type transposons which are then repeatedly and independently acquired by vancomycin-susceptible E. faecium isolates.…”

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

The human gut resistome

Schaik

2015

Phil. Trans. R. Soc. B

303

244

View full text Add to dashboard Cite

In recent decades, the emergence and spread of antibiotic resistance among bacterial pathogens has become a major threat to public health. Bacteria can acquire antibiotic resistance genes by the mobilization and transfer of resistance genes from a donor strain. The human gut contains a densely populated microbial ecosystem, termed the gut microbiota, which offers ample opportunities for the horizontal transfer of genetic material, including antibiotic resistance genes. Recent technological advances allow microbiota-wide studies into the diversity and dynamics of the antibiotic resistance genes that are harboured by the gut microbiota (‘the gut resistome’). Genes conferring resistance to antibiotics are ubiquitously present among the gut microbiota of humans and most resistance genes are harboured by strictly anaerobic gut commensals. The horizontal transfer of genetic material, including antibiotic resistance genes, through conjugation and transduction is a frequent event in the gut microbiota, but mostly involves non-pathogenic gut commensals as these dominate the microbiota of healthy individuals. Resistance gene transfer from commensals to gut-dwelling opportunistic pathogens appears to be a relatively rare event but may contribute to the emergence of multi-drug resistant strains, as is illustrated by the vancomycin resistance determinants that are shared by anaerobic gut commensals and the nosocomial pathogen Enterococcus faecium.

show abstract

Section: Discussion and Future Perspectivesmentioning

confidence: 99%

The human gut resistome

Schaik

2015

Phil. Trans. R. Soc. B

303

244

View full text Add to dashboard Cite

show abstract

“…with intrinsic glycopeptid resistance e.g. E. gallinarum remain rare [ 2 , 32 ]. (iii) Since we used surveillance definitions to determine infections, in some cases of UTIs the identified VRE might have been a contamination rather than the infection-causing pathogen.…”

Section: Discussionmentioning

confidence: 99%

Continuous increase of vancomycin resistance in enterococci causing nosocomial infections in Germany − 10 years of surveillance

Remschmidt

Schröder

Behnke

et al. 2018

Antimicrob Resist Infect Control

121

View full text Add to dashboard Cite

BackgroundEnterococci are frequent pathogens causing nosocomial infections in Germany. Infections due to strains with vancomycin resistance are high when compared with other European states. Therefore, the study aimed to describe the recent progression of nosocomial infections due to vancomycin-resistant enterococci (VRE) in Germany.MethodsWe analyzed data from two components of the German national nosocomial infection surveillance system for the period 2007–2016. For primary bloodstream infections (BSIs) and urinary tract infections (UTIs) we used data from intensive care units and for surgical site infections (SSIs) data from surgical departments. In a sensitivity analysis, we considered only data from participants that participated continuously from 2007 to 2016 (“core group”). We calculated proportions of VRE among all nosocomial enterococcal infections with 95% confidence intervals (95% CIs) and trends over time. A multivariable logistic regression was used to compare occurrence of VRE proportions among German federal states.ResultsEnterococcal infections from 857 ICUs and 1119 surgical departments were analyzed. On ICUs, the proportion of vancomycin resistance in enterococci causing nosocomial infections significantly increased for BSIs from 5.9 to 16.7% and for UTIs from 2.9 to 9.9%; for surgical site infections, the proportion of VRE increased from 0.9 to 5.2% (P < 0.001 for all). In the core group, the increase of VRE was more pronounced in ICUs (BSIs: 5.5 to 21.6%; UTIs: 2 to 11.2%) but was not seen in surgical departments (SSIs: 1.5 to 2.8%). Compared with the most populous German federal state North Rhine Westphalia, enterococcal infections in Hesse (Odds Ratio (OR) 2.3, 95% CI 1.7–3.1), Saxony (OR 2.5, 95% CI 1.8–3.5) and Thuringia (OR 1.9, 95% CI 1.4–2.6) were more likely to be caused by vancomycin-resistant strains.ConclusionIn Germany, the proportion of VRE in nosocomial infection due to enterococci is still increasing. It remains unclear, why a large variation in the proportion of VRE exists between German federal states.

show abstract

“…Both species exhibit high levels of resistance against the aminoglycosides, and E. faecium is inherently resistant to β-lactam antibiotics. Currently, most isolates of E. faecium are highly resistant to ampicillin, while a non-negligible proportion exhibit high-level resistance to aminoglycosides and are resistant to glycopeptides, causing outbreaks in clinical settings [19]. …”

Section: Discussionmentioning

confidence: 99%

Does antibiotic resistance impair plasma susceptibility of multi-drug resistant clinical isolates of enterococci in vitro?

et al. 2016

View full text Add to dashboard Cite

BackgroundCold atmospheric plasma could constitute an alternative against multi-drug resistant pathogens. Susceptibility of enterococci to cold atmospheric plasma was investigated in vitro.Methods39 clinical isolates of enterococci were grouped dependent on the most important resistance patterns and treated on agar using dielectric barrier discharge plasma. These included enterococci with combined vancomycin- and high-level gentamicin resistance, high-level resistance to gentamicin (HLGR) only, vancomycin resistance alone (VRE), and enterococci susceptible to both. Susceptibility to cold atmospheric plasma was evaluated based on the zones of inhibition and examined in terms of the enterococcal group and the “degree” of drug resistance.ResultsCold atmospheric plasma treatment killed all groups. Comparison of VRE and HLGR strains with non-VRE and non-HLGR isolates concerning zones of inhibition revealed that enterococci with special resistance patterns (VRE and HLGR) showed significantly smaller zones of inhibition than the sensitive ones. The mean of all isolates, irrespective of belonging to groups, showed smaller zones of inhibition with increasing “degree” of drug resistance.ConclusionsCold atmospheric plasma treatment killed all isolates of enterococci, but its efficacy depended on the “degree” of drug resistance and on membership in special resistance groups with particular clinical-outbreak importance. However, a possible role of the different genetic lineages, which might be prone to acquiring more or less resistance phenotypes, may also play a role in this context.Electronic supplementary materialThe online version of this article (doi:10.1186/s13099-016-0122-4) contains supplementary material, which is available to authorized users.

show abstract

Vancomycin-resistente Enterokokken (VRE)

Cited by 34 publications

References 59 publications

The human gut resistome

The human gut resistome

Continuous increase of vancomycin resistance in enterococci causing nosocomial infections in Germany − 10 years of surveillance

Does antibiotic resistance impair plasma susceptibility of multi-drug resistant clinical isolates of enterococci in vitro?

Contact Info

Product

Resources

About