Resistance in Vancomycin-Resistant Enterococci

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

doi:10.1016/j.idc.2020.08.004

Resistance in Vancomycin-Resistant Enterococci

Infect Dis Clin North Am. 2020 Dec;34(4):751-771. doi: 10.1016/j.idc.2020.08.004.

Authors

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

Affiliations

¹ Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St. MSB 2.112, Houston, TX 77030, USA; Center for Antimicrobial Resistance and Microbial Genomics (CARMiG).
² Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St. MSB 2.112, Houston, TX 77030, USA; Center for Antimicrobial Resistance and Microbial Genomics (CARMiG); Department of Microbiology and Molecular Genetics, 6431 Fannin St. MSB 2.112, Houston, TX 77030, USA.
³ Department of Internal Medicine, Brown University, 593 Eddy Street, Providence, RI 02903, USA.
⁴ Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St. MSB 2.112, Houston, TX 77030, USA; Center for Antimicrobial Resistance and Microbial Genomics (CARMiG); Department of Microbiology and Molecular Genetics, 6431 Fannin St. MSB 2.112, Houston, TX 77030, USA; University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. Electronic address: Cesar.Arias@uth.tmc.edu.

Abstract

Serious infections owing to vancomycin-resistant enterococci have historically proven to be difficult clinical cases, requiring combination therapy and management of treatment-related toxicity. Despite the introduction of new antibiotics with activity against vancomycin-resistant enterococci to the therapeutic armamentarium, significant challenges remain. An understanding of the factors driving the emergence of resistance in vancomycin-resistant enterococci, the dynamics of gastrointestinal colonization and microbiota-mediated colonization resistance, and the mechanisms of resistance to the currently available therapeutics will permit clinicians to be better prepared to tackle these challenging hospital-associated pathogens.

Keywords: Colonization resistance; Mechanisms of resistance; VRE; VRE colonization; Vancomycin resistant enterococcus.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Anti-Bacterial Agents / adverse effects*
Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Cross Infection / drug therapy
Cross Infection / microbiology
Drug Resistance, Multiple, Bacterial* / drug effects
Enterococcus faecium / drug effects
Enterococcus faecium / isolation & purification
Gastrointestinal Microbiome / drug effects*
Gram-Positive Bacterial Infections / drug therapy
Gram-Positive Bacterial Infections / microbiology*
Humans
Vancomycin-Resistant Enterococci / drug effects
Vancomycin-Resistant Enterococci / isolation & purification

Substances

Anti-Bacterial Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding