Glycopeptide-resistant enterococci: deciphering virulence, resistance and epidemicity
- 1 August 2007
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Infectious Diseases
- Vol. 20 (4), 384-390
- https://doi.org/10.1097/qco.0b013e32818be63d
Abstract
Since their first discovery, glycopeptide-resistant enterococci have emerged as important nosocomial pathogens first in the US, followed by the rest of the world. In this review the most recent findings that relate to enterococcal epidemiology, virulence and glycopeptide-resistance maintenance will be discussed. Frequent horizontal gene transfer and recombination, resulting in high-level genome plasticity, facilitating rapid responsiveness of enterococci to changing environmental conditions may have contributed to the worldwide emergence. For Enterococcus faecium this has resulted in the development of a distinct genetic subspecies, clonal complex 17, responsible for the majority of glycopeptide-resistant enterococci-related hospital burden. Preliminary data also suggest that such high-risk enterococcal clonal complexes may exist within Enterococcus faecalis. The last 2 years have not only disclosed novel determinants implicated in enterococcal pathogenesis, but also showed that enterococci are able to sense their environment and regulate virulence gene expression accordingly. Linkage of glycopeptide resistance in enterococci to plasmid maintenance systems holds a doomed perspective for controlling antibiotic resistance emergence. Recent developments have improved our understanding of enterococcal population structure, pathogenesis and glycopeptide-resistance maintenance. This may contribute to the development of novel intervention strategies to prevent enterococcal infections and contain the spread of glycopeptide-resistant enterococci.Keywords
This publication has 73 references indexed in Scilit:
- First isolation of vancomycin-resistant enteroccoci and spread of a single clone in a university hospital in northwestern TurkeyEuropean Journal of Clinical Microbiology & Infectious Diseases, 2007
- Molecular epidemiology of vancomycin-resistant Enterococcus faecium in ArgentinaInternational Journal of Infectious Diseases, 2007
- High frequency of vancomycin-resistant Enterococcus faecium isolates with VanB phenotype and vanA genotype in Korean hospitalsDiagnostic Microbiology and Infectious Disease, 2006
- Multilocus sequence typing and analysis of putative virulence factors in vancomycin-resistant and vancomycin-sensitive Enterococcus faecium isolates from BrazilClinical Microbiology & Infection, 2006
- Emergence of epidemic clones of vancomycin-resistant Enterococcus faecium in SingaporeJournal of Hospital Infection, 2006
- Multilocus Sequence Typing of Hospital-Associated Enterococcus faecium from Brazil Reveals Their Unique Evolutionary HistoryMicrobial Drug Resistance, 2006
- Risk factors for the acquisition of vancomycin-resistant enterococci during a single-strain outbreak at a major Australian teaching hospitalJournal of Hospital Infection, 2006
- Emerging Incidence of Enterococcus faecium among Hospital Isolates (1993 to 2002)Journal of Clinical Microbiology, 2005
- Effect of Abolishment of the Use of Antimicrobial Agents for Growth Promotion on Occurrence of Antimicrobial Resistance in Fecal Enterococci from Food Animals in DenmarkAntimicrobial Agents and Chemotherapy, 2001
- Decreased Incidence of VanA-type Vancomycin-Resistant Enterococci Isolated from Poultry Meat and from Fecal Samples of Humans in the Community after Discontinuation of Avoparcin Usage in Animal HusbandryMicrobial Drug Resistance, 1999