Analysis Of Selected Genetic Traits, Phenotypes, And The Epidemiological Threat Of Enterococcus Bacteria Resistant To Vancomycin

Enterococci are Gram-positive bacteria that belong to facultative anaerobic cocci. Species belonging to the Enterococcus genus generally display little infectious potential, although they can cause serious nosocomial infections. The groups at high risk include patients with proliferative diseases, chronic liver diseases, and graft recipients. Since 1980s infections with enterococci resistant to numerous antibiotics have been observed with increasing frequency. There are two independent ways of developing resistance to vancomycin, connected with the common use of vancomycin for MRSA treatment and the non-medical use of this antibiotic. Nine phenotypes of vancomycin-resistant enterococcal strains can be distinguished: VanA, VanB, VanC, VanD, VanE, VanG, VanL, VanM, VanN. These phenotypes differ at the molecular level to a different extent. Current treatments of enterococcal infections usually include drugs such as linezolid, quinupristin/dalfopristin, daptomycin, tigecycline, and chloramphenicol. Data available from Europe and other parts of the world indicate a constant increase in the number of emerging VRE isolates, as well as strains resistant to antibiotics other than vancomycin.

1. Introduction. 2. Infections with enterococci. 3. Treatment of enterococcal infections and antimicrobial resistance. 4. Development of VRE phenomenon. 5. Drugs used to control infections with VRE strains. 6. Routes of VRE spread. 7. VRE phenotypes. 8. Molecular characteristics of VRE phenotypes. 9. Epidemiological situation in the world. 10. Epidemiological situation in Poland. 11. Epidemiological situation in Europe. 12. Summary