Vancomycin-Variable Enterococcal Bacteremia

Downing, Mark; Xiong, Ji; Eshaghi, Alireza; McGeer, Allison; Patel, Samir N.; Johnstone, Jennie

doi:10.1128/jcm.02046-15

Cited by 7 publications

(9 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Transmission of the vanA gene cassette is largely due to horizontal gene transfer of plasmids containing Tn 1546 -like elements [ 9 ]. Because this also seems to be the case for VVE, and because the frequent genetic rearrangements mean that VVE can be either resistant or susceptible to vancomycin, we believe that control of VVE in our geographic area will be important if we wish to protect our hospitals and patients from VRE [ 7 ]. Institutions or regions wishing to prevent the development of endemic VRE within their hospitals should be alert to the risk of VVE strains, and should consider using PCR for vanA/vanB genes for screening to contain their spread as needed.…”

Section: Discussionmentioning

confidence: 99%

“…Because of their susceptibility to vancomycin, VVE escape the traditional detection methods for vancomycin-resistant enterococci (VRE), which might be associated with under-diagnosing and silent dissemination of VVE in healthcare facilities. Indeed, VVE have often been reported as clusters causing hospital outbreaks [ 3 – 5 , 7 ]. Worryingly, both in vivo and in vitro data show that VVE have the ability to revert into vancomycin-resistant phenotypes upon vancomycin exposure [ 5 , 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of vancomycin-variable Enterococcus faecium (VVE) among vanA-positive sterile site isolates and patient factors associated with VVE bacteremia

et al. 2018

View full text Add to dashboard Cite

Vancomycin-variable enterococci (VVE) are vanA-positive, vancomycin-susceptible enterococci with the ability to revert to a vancomycin-resistant phenotype on exposure to vancomycin. We sought to assess the prevalence of VVE and to determine clinical characteristics of patients infected with VVE. We prospectively collected Enterococcus faecium sterile site isolates from Toronto Invasive Bacterial Diseases Network hospitals from January 2015 to June 2016 and calculated VVE (defined as vanA-positive, vancomycin-susceptible isolates) prevalence among vanA-containing isolates. We performed chart reviews of VVE and vancomycin-resistant E. faecium (VRE) bacteremias identified from January 2012 to June 2016, and on a random sample of patients with bacteremia due to vanA/vanB-negative, vancomycin-susceptible enterococci (VSE) from January 2015 to June 2016. Clinical characteristics were compared and factors associated with mortality assessed. Because of the potential reversion from VVE to VRE, pulsed-field gel electrophoresis (PFGE) was performed for strains causing breakthrough bacteremia in order to identify relatedness among strains with different phenotypic resistance within the same patient. VVE comprised 47% (18/38) of vanA-positive isolates. The charts of 36 VRE, 25 VVE, and 79 VSE patients were reviewed. Central venous catheter associated bacteremia was more common in VVE (44%) and VRE patients (57%) than in VSE patients (28%) (P = 0.01). The Pitt bacteremia (OR 1.3, P = 0.002) and the Charlson score (OR 1.2, P = 0.008) were the only independent mortality predictors. PFGE of strains causing breakthrough bacteremia showed high within-patient clonality, irrespective of vanA-positivity or vancomycin-susceptibility. A substantial proportion of vanA-positive isolates are VVE and are therefore not detected with conventional selective culture methods. Bacteremia sources of patients with VVE are similar to those infected with VRE. We detected no association between VVE and 30-day mortality or breakthrough bacteremia.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of vancomycin-variable Enterococcus faecium (VVE) among vanA-positive sterile site isolates and patient factors associated with VVE bacteremia

et al. 2018

View full text Add to dashboard Cite

show abstract

“…This bacteraemia case with VVE and MRSA raises several important questions, previously discussed by Downing et al 6 Should vancomycin be avoided in patients with serious VVE infections? A patient colonised with this organism was recently described, and it was shown that the isolate developed resistance to vancomycin in vivo during vancomycin therapy.…”

mentioning

confidence: 87%

“…as well as recognition of relatively frequent detection of MPO mRNA in ALL blasts, which does not correlate consistently with immunophenotyping and cytochemical findings. 1,6 Advances in molecular techniques have resulted in better subclassification of acute leukaemias and improved diagnostic certainty. 2,6 Several sequencing studies have demonstrated a large degree of genomic heterogeneity in MPAL as well as differences between MPAL subtypes (B/myeloid and T/myeloid), although notably only a small number of triphenotypic leukaemia were included in these studies.…”

mentioning

confidence: 99%

“…1,6 Advances in molecular techniques have resulted in better subclassification of acute leukaemias and improved diagnostic certainty. 2,6 Several sequencing studies have demonstrated a large degree of genomic heterogeneity in MPAL as well as differences between MPAL subtypes (B/myeloid and T/myeloid), although notably only a small number of triphenotypic leukaemia were included in these studies. 9,10 MLLT10 (also known as AF10) fusions involving multiple partner genes, including DDX3X, have been reported in both paediatric and adult T-acute lymphoblastic leukaemia and MPAL.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Vancomycin variable Enterococcus (VVE), E. faecium, harbouring the vanA gene complex

Merlino

Gray

2021

Pathology

View full text Add to dashboard Cite

High prevalence of vancomycin non-susceptible and multi-drug resistant enterococci in farmed animals and fresh retail meats in Bangladesh

et al. 2022

View full text Add to dashboard Cite

The emergence of antimicrobial resistant Enterococcus spp., a leading cause of untreatable nosocomial infection, in food animals and dissemination to humans is a public health concern. The study was conducted to determine the prevalence and antimicrobial resistance, and virulence characteristics of Enterococcus faecalis and Enterococcus faecium in food animals and meats in Bangladesh. Enterococcus spp., were con rmed using sodA gene speci c PCR, and antimicrobial resistance and virulence properties were characterized by PCR. Enterococcus spp. were recovered from 57% of the collected samples (n=201/352). Farm samples yielded signi cantly higher (p≤0.05) prevalence (62%) compared to retail meat samples (41%) and E. faecalis (52%) was most frequently isolated species. High proportions of isolates exhibited resistance to tetracycline (74%), erythromycin (65%) and cipro oxacin (34%). Fifty-one isolates were vancomycin non-susceptible enterococci (VNSE), of which forty-seven were MDR and 20 were linezolid resistant, a last line drug for VNSE.Virulence factors such as gelatinase (gelE), aggregation factor (asa1) and sex pheromone (cpd) were detected along with vancomycin resistance gene (vanA, vanB and vanC2/C3) in VNSE isolates. The high prevalence of MDR enterococci in food animals and retail meats may lead to infection in consumers with concomitant reduced therapeutic options available for treatment.

show abstract

Vancomycin-Variable Enterococcal Bacteremia

Cited by 7 publications

References 7 publications

Prevalence of vancomycin-variable Enterococcus faecium (VVE) among vanA-positive sterile site isolates and patient factors associated with VVE bacteremia

Prevalence of vancomycin-variable Enterococcus faecium (VVE) among vanA-positive sterile site isolates and patient factors associated with VVE bacteremia

Vancomycin variable Enterococcus (VVE), E. faecium, harbouring the vanA gene complex

High prevalence of vancomycin non-susceptible and multi-drug resistant enterococci in farmed animals and fresh retail meats in Bangladesh

Contact Info

Product

Resources

About