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Vancomycin resistance: status quo and quo vadis
H P Endtz1, N van den Braak, H A Verbrugh
1Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center Rotterdam, The Netherlands. endtz@bacl.azr.nl
Summary
Vancomycin resistance in Enterococcus spp. is increasing, complicating treatment. This review examines resistance genes, epidemiology, and the spread of vancomycin resistance to other bacteria like staphylococci.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Rising prevalence of vancomycin resistance in clinical Enterococcus spp. isolates.
- Limited treatment options for infections caused by vancomycin-resistant enterococci.
- Elucidation of glycopeptide resistance genes and their epidemiology.
Purpose of the Study:
- Review the prevalence of vancomycin-resistant enterococci in clinical and environmental settings.
- Discuss the relationship with nosocomial and veterinary glycopeptide use.
- Explore the epidemiology of vancomycin resistance traits.
Main Methods:
- Review of existing literature on vancomycin resistance in Enterococcus spp.
- Discussion of studies on gene reservoirs and strain epidemiology.
- Application of novel molecular tools for identifying resistance genes and genomes.
Main Results:
- Vancomycin resistance is a growing concern in Enterococcus spp.
- The spread of vancomycin resistance to other bacterial species, such as staphylococci, is a significant risk.
- Molecular tools enhance understanding of resistance epidemiology.
Conclusions:
- The increasing prevalence and spread of vancomycin resistance necessitate ongoing surveillance and research.
- Understanding the epidemiology is crucial for developing effective control strategies.
- The emergence of resistance in other bacteria highlights the broader threat of antimicrobial resistance.