Journal ArticleDOI
Concomitant High-Level Vancomycin and Penicillin Resistance in Clinical Isolates of Enterococci
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TLDR
Three clinical isolates from three New York City hospitals that demonstrated concomitant resistance to vancomycin (one VanA, two VanB phenotypes) and high-level resistance to penicillin were characterized.Abstract:Â
Enterococci are important nosocomial pathogens among which resistance to multiple antibiotics is being recognized with increasing frequency. We characterized three clinical isolates from three New York City hospitals that demonstrated concomitant resistance to vancomycin (one VanA, two VanB phenotypes) and high-level resistance to penicillin. Two Enterococcus faecium strains were intrinsically highly resistant to penicillin and showed very low affinity for penicillin of penicillin-binding protein 5. Unlike previously described glycopeptide-resistant enterococci, these strains were not hypersusceptible to beta-lactam agents after vancomycin induction, and combinations of penicillin and vancomycin were not synergistic against them. A third isolate, Enterococcus faecalis, produced beta-lactamase. Two of the three strains were also highly resistant to all aminoglycosides. Emergence of concomitant high-level resistance to multiple antibiotic classes among enterococci considerably narrows the therapeutic options for treatment of infections due to these opportunistic pathogens.read more
Citations
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Journal ArticleDOI
Vancomycin-resistant enterococci.
TL;DR: This work reviews VRE, including their history, mechanisms of resistance, epidemiology, control measures, and treatment, and raises significant concerns about the emergence of vancomycin-resistant Staphylococcus aureus.
Journal ArticleDOI
Genetics and mechanisms of glycopeptide resistance in enterococci.
Michel Arthur,Patrice Courvalin +1 more
TL;DR: The experimental approaches used to characterize the molecular basis of VanA resistance are reviewed and the similarities and differences between the VanA phenotype and other phenotypes are briefly discussed.
Journal ArticleDOI
Characterization of glycopeptide-resistant enterococci from U.S. hospitals.
TL;DR: Pulsed-field gel electrophoresis demonstrated both intrahospital and interhospital diversity among Vmr enterococci in the United States and was more useful than plasmid analysis for epidemiologic studies.
Journal ArticleDOI
Glycopeptide resistance in enterococci
TL;DR: Glycopeptide resistance in enterococci results from the production of peptidoglycan precursors with low affinity for these antibiotics, and the mobility of the resistance genes by transposition and conjugation and the ability of the resistant proteins to interfere with synthesis of normal precursor in different hosts indicate that dissemination into other bacterial species should be anticipated.
Journal ArticleDOI
Outbreak of vancomycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium bacteremia in an adult oncology unit.
M. A. Montecalvo,Harold W. Horowitz,C. Gedris,Carol A. Carbonaro,F. C. Tenover,Abdul Issah,P. Cook,Gary P. Wormser +7 more
TL;DR: It was found that bacteremic patients received a significantly greater number of total antibiotic days compared with noninfected stool carriers, and the emergence of E. faecium with high-level resistance to vancomycin, ampicillin, and aminoglycosides underscores the importance of performing susceptibility testing on all clinically significant isolates.
References
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Journal ArticleDOI
The life and times of the Enterococcus.
TL;DR: Enterococci are important human pathogens that are increasingly resistant to antimicrobial agents, including resistance to cephalosporins, clindamycin, tetracycline, and penicillinase-resistant penicillins such as oxacillin, among others.
Journal ArticleDOI
Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium.
TL;DR: The glycopeptide antibiotic agents vancomycin and teicoplanin are useful in the treatment of severe infections due to gram-positive bacteria.
Journal ArticleDOI
In vitro susceptibility studies of vancomycin-resistant Enterococcus faecalis.
TL;DR: Vancomycin resistance exhibited by E faecalis isolates V583, V586, and V587 is described in this article, where vancomycin MICs ranged from 32 to 64 micrograms/ml.
Journal ArticleDOI
High-level vancomycin-resistant enterococci causing hospital infections.
AnneH.C. Uttley,R C George,Jay Naidoo,Neil Woodford,Alan P. Johnson,C H Collins,Donald Morrison,A Gilfillan,L E Fitch,J Heptonstall +9 more
TL;DR: Nosocomial infection or colonization due to enterococci with high-level resistance to vancomycin (minimal inhibitory concentrations [MICs] between 64 and > 2000 mg/L) has occurred in 41 patients with renal disease.
Journal ArticleDOI
Nosocomial Infection by Gentamicin-Resistant Streptococcus faecalis: An Epidemiologic Study
Marcus J. Zervos,Carol A. Kauffman,Patricia M. Therasse,Alice G. Bergman,Teresa S. Mikesell,Dennis R. Schaberg +5 more
TL;DR: Nosocomial acquisition and interhospital spread of gentamicin-resistant enterococci was shown to have occurred when plasmid content was used as an epidemiologic marker.