Vancomycin-Resistant Enterococci

Excerpt

Antimicrobial resistance is becoming an increasingly common clinical dilemma for medical providers. In particular, vancomycin-resistant Enterococcus (VRE) has become a challenge to manage in the hospital setting. Enterococci are facultative anaerobic gram-positive cocci in pairs/chains that live in the gastrointestinal (GI) tract and ordinarily function commensally with humans. However, they can cause a variety of infections, most commonly urinary tract infection (UTI), intraabdominal infection, bacteremia, or endocarditis. Rarely, they can cause meningitis, osteomyelitis, septic arthritis, or pneumonia. Additionally, vancomycin-resistant Enterococcus often exists as a colonizing organism that does not always contribute to infection, making it more difficult to determine when and how to treat these infections. Despite these difficulties, infection of vancomycin-resistant Enterococcus has been shown to increase both cost and mortality when compared to vancomycin-susceptible isolates. With increasing rates of vancomycin resistance among Enterococcus isolates, good stewardship combined with aggressive treatment with targeted antibiotics is necessary to treat this frequently encountered infection.