Vancomycin-Dependent Enterococcal Strains: Case Report and Review

Yowler, Charles J.; Blinkhorn, Richard; Fratianne, Richard B.

doi:10.1097/00005373-200004000-00035

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…As a result, they express the resistant phenotype without a substantial reduction in fitness. In fact, loss of the ddl gene in other van cluster-containing enterococci (most commonly VanB) leads to vancomycin dependence as these bacteria are unable to synthesize normal peptidoglycan precursors and require the presence of vancomycin to activate the van operon in order to build a cell wall [51]. In this case, restoration of normal growth occurs with either a ‘gain-of-function’ mutation of ddl or constitutive expression of the van operon [52].…”

Section: Mechanisms Of Resistance To Cell-wall Active Agentsmentioning

confidence: 99%

Mechanisms of antibiotic resistance in enterococci

Miller¹,

Munita

Arias

2014

Expert Review of Anti-infective Therapy

566

481

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Multidrug-resistant (MDR) enterococci are important nosocomial pathogens and a growing clinical challenge. These organisms have developed resistance to virtually all antimicrobials currently used in clinical practice using a diverse number of genetic strategies. Due to this ability to recruit antibiotic resistance determinants, MDR enterococci display a wide repertoire of antibiotic resistance mechanisms including modification of drug targets, inactivation of therapeutic agents, overexpression of efflux pumps and a sophisticated cell envelope adaptive response that promotes survival in the human host and the nosocomial environment. MDR enterococci are well adapted to survive in the gastrointestinal tract and can become the dominant flora under antibiotic pressure, predisposing the severely ill and immunocompromised patient to invasive infections. A thorough understanding of the mechanisms underlying antibiotic resistance in enterococci is the first step for devising strategies to control the spread of these organisms and potentially establish novel therapeutic approaches.

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Section: Mechanisms Of Resistance To Cell-wall Active Agentsmentioning

confidence: 99%

Mechanisms of antibiotic resistance in enterococci

Miller¹,

Munita

Arias

2014

Expert Review of Anti-infective Therapy

566

481

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“…In all cases, patients have had courses of broad spectrum antibiotics including vancomycin [ 7 , 65 ]. Subsequently, vancomycin dependence has been reported for Enterococci as E. faecalis [ 10 , 66 – 68 ], E. faecium [ 67 , 69 – 85 ] and Enterococcus avium [ 86 ], and also in S. aureus [ 87 , 88 ].…”

Section: Bacterial Dependence On Vancomycinmentioning

confidence: 99%

Fierce poison to others: the phenomenon of bacterial dependence on antibiotics

2023

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Beyond the development of resistance, the effects of antibiotics on bacteria and microbial communities are complex and far from exhaustively studied. In the context of the current global antimicrobial resistance crisis, understanding the adaptive and physiological responses of bacteria to antimicrobials is of paramount importance along with the development of new therapies. Bacterial dependence on antibiotics is a phenomenon in which antimicrobials instead of eliminating the pathogens actually provide a boost for their growth. This trait comprises an extreme example of the complexities of responses elicited by microorganisms to these drugs. This compelling evolutionary trait was readily described along with the first wave of antibiotics use and dependence to various antimicrobials has been reported. Nevertheless, current molecular characterizations have been focused on dependence on vancomycin, linezolid and colistin, three critically important antibiotics frequently used as last resource therapy for multi resistant pathogens. Outstanding advances have been made in understanding the molecular basis for the dependence to vancomycin, including specific mutations involved. Regarding linezolid and colistin, the general physiological components affected by the dependence, namely ribosomes and membrane function respectively, have been established. Nonetheless the implications of antibiotic dependence in clinically relevant features, such as virulence, epidemics, relationship with development of resistance, diagnostics and therapy effectiveness require clarification. This review presents a brief introduction of the phenomenon of bacterial dependence to antibiotics and a summary on early and current research concerning the basis for this trait. Furthermore, the available information on the effect of dependence in key clinical aspects is discussed. The studies performed so far underline the need to fully disclose the biological and clinical significance of this trait in pathogens to successfully assess its role in resistance and to design adjusted therapies.

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“…Unfortunately, suspension of vancomycin treatment may be insufficient to cure VDE infections due to the rapid reversion of VDE to vancomycin-independent colonies in vitro [ 440 ], likely through further mutations that allow re-activation of D-Ala-D-Ala synthesis or constitutive activation of an alternative van pathway [ 82 ]. Although rare, VDE infections in human patients have been reported in the literature [ 439 , 440 , 441 , 443 , 444 , 445 , 446 , 447 , 448 ]. However, due to the infrequent nature of such infections, VDE are poorly studied and understood, while optimum treatment guidelines remain unclear [ 445 ].…”

Section: Vancomycinmentioning

confidence: 99%

Vancomycin Resistance in Enterococcus and Staphylococcus aureus

Walker

Oliveira

2022

Microorganisms

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Enterococcus faecalis, Enterococcus faecium and Staphylococcus aureus are both common commensals and major opportunistic human pathogens. In recent decades, these bacteria have acquired broad resistance to several major classes of antibiotics, including commonly employed glycopeptides. Exemplified by resistance to vancomycin, glycopeptide resistance is mediated through intrinsic gene mutations, and/or transferrable van resistance gene cassette-carrying mobile genetic elements. Here, this review will discuss the epidemiology of vancomycin-resistant Enterococcus and S. aureus in healthcare, community, and agricultural settings, explore vancomycin resistance in the context of van and non-van mediated resistance development and provide insights into alternative therapeutic approaches aimed at treating drug-resistant Enterococcus and S. aureus infections.

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Vancomycin-Dependent Enterococcal Strains: Case Report and Review

Cited by 8 publications

References 10 publications

Mechanisms of antibiotic resistance in enterococci

Mechanisms of antibiotic resistance in enterococci

Fierce poison to others: the phenomenon of bacterial dependence on antibiotics

Vancomycin Resistance in Enterococcus and Staphylococcus aureus

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