Vancomycin-Variable Enterococcal Bacteremia

M A Downing; J Xiong; A Eshaghi; A McGeer; S N Patel; J Johnstone

doi:10.1128/JCM.02046-15

Vancomycin-Variable Enterococcal Bacteremia

J Clin Microbiol. 2015 Dec;53(12):3951-3. doi: 10.1128/JCM.02046-15. Epub 2015 Sep 30.

Authors

M A Downing¹, J Xiong², A Eshaghi³, A McGeer⁴, S N Patel⁵, J Johnstone⁶

Affiliations

¹ St. Joseph's Health Centre, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada.
² St. Joseph's Health Centre, Toronto, ON, Canada.
³ Public Health Ontario, Toronto, ON, Canada.
⁴ Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada Mount Sinai Hospital, Toronto, ON, Canada.
⁵ Public Health Ontario, Toronto, ON, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
⁶ St. Joseph's Health Centre, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Public Health Ontario, Toronto, ON, Canada jennie.johnstone@oahpp.ca.

Abstract

Vancomycin-variable enterococcus (VVE) is an emerging pathogen. VVE isolates initially appear phenotypically susceptible to vancomycin but possesses the vanA gene and can develop in vitro and in vivo resistance to vancomycin. We report a case of VVE bacteremia and describe how VVE poses diagnostic and therapeutic dilemmas.

Publication types

Case Reports

MeSH terms

Aged
Anti-Bacterial Agents / pharmacology*
Bacteremia / microbiology*
Bacterial Proteins / genetics
Carbon-Oxygen Ligases / genetics
Electrophoresis, Gel, Pulsed-Field
Enterococcus / classification
Enterococcus / drug effects*
Enterococcus / genetics
Enterococcus / isolation & purification*
Female
Gram-Positive Bacterial Infections / microbiology*
Humans
Microbial Sensitivity Tests
Molecular Typing
Vancomycin / pharmacology*
Vancomycin Resistance*

Substances

Anti-Bacterial Agents
Bacterial Proteins
VanA ligase, Bacteria
Vancomycin
Carbon-Oxygen Ligases