Intrinsically vancomycin-resistant gram-positive organisms: clinical relevance and implications for infection control

Area of Science:

• Microbiology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Intrinsic vancomycin resistance in gram-positive bacteria predates acquired resistance.
• Genera like Enterococci (vanC gene), Leuconostoc, Lactobacillus, Pediococcus, and Erysipelothrix can cause human infections.
• This resistance mechanism is gaining recent attention.

Purpose of the Study:

• To review current data on intrinsically vancomycin-resistant gram-positive bacteria.
• To examine their identification, resistance mechanisms, epidemiology, and clinical relevance.
• To assess their antimicrobial susceptibility and treatment options.

Main Methods:

• Literature review of existing studies.
• Analysis of data on identification methods.
• Examination of epidemiological and clinical case reports.
• Assessment of antimicrobial susceptibility testing results.

Main Results:

• Intrinsically vancomycin-resistant gram-positives are often opportunistic pathogens.
• Serious infections can occur, but viable treatment strategies exist.
• Current evidence does not support enhanced infection control measures for these specific genera.

Conclusions:

• Vigilance is necessary to monitor for evolving susceptibility patterns.
• Treatment options for infections caused by these bacteria remain available.
• Further research into intrinsic resistance mechanisms is warranted.