Vancomycin-Resistant Enterococci: Therapeutic Challenges in the 21st Century

William R Miller; Barbara E Murray; Louis B Rice; Cesar A Arias

doi:10.1016/j.idc.2016.02.006

Vancomycin-Resistant Enterococci: Therapeutic Challenges in the 21st Century

Infect Dis Clin North Am. 2016 Jun;30(2):415-439. doi: 10.1016/j.idc.2016.02.006.

Authors

William R Miller¹, Barbara E Murray², Louis B Rice³, Cesar A Arias⁴

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA.
² Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA; Department of Microbiology and Molecular Genetics, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA.
³ Departments of Medicine, Microbiology and Immunology, Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903, USA.
⁴ Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA; Department of Microbiology and Molecular Genetics, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Avenue Cra 9 No. 131 A - 02, Bogotá, Colombia. Electronic address: Cesar.Arias@uth.tmc.edu.

PMID: 27208766
DOI: 10.1016/j.idc.2016.02.006

Abstract

Vancomycin-resistant enterococci are serious health threats due in part to their ability to persist in rugged environments and their propensity to acquire antibiotic resistance determinants. Enterococci have now established a home in our hospitals and possess mechanisms to defeat most currently available antimicrobials. This article reviews the history of the struggle with this pathogen, what is known about the traits associated with its rise in the modern medical environment, and the current understanding of therapeutic approaches in severe infections caused by these microorganisms. As the 21st century progresses, vancomycin-resistant enterococci continue to pose a daunting clinical challenge.

Keywords: Antibiotic resistance; Combination therapy; Vancomycin resistant enterococcus.

Publication types

Review

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Drug Therapy, Combination
Gram-Positive Bacterial Infections* / drug therapy
Gram-Positive Bacterial Infections* / microbiology
Humans
Vancomycin Resistance*
Vancomycin-Resistant Enterococci*

Substances

Anti-Bacterial Agents