Related Experiment Videos
Vancomycin-resistant enterococci: why are they here, and where do they come from?
M J Bonten1, R Willems, R A Weinstein
1Department of Internal Medicine and the Eijkman-Winkler Institute for Microbiology, Infectious Diseases, and Inflammation, University Medical Center Utrecht, The Netherlands. m.j.m.bonten@digd.azu.nl
The Lancet. Infectious Diseases
|March 2, 2002
Summary
Vancomycin-resistant enterococci (VRE) are a growing concern. Differences in antibiotic use between the USA and Europe explain VRE
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Vancomycin-resistant enterococci (VRE) have emerged as significant nosocomial pathogens.
- VRE colonization is endemic in US hospitals but absent in healthy individuals.
- In Europe, VRE colonization is endemic in healthy people and animals, with sporadic outbreaks.
Purpose of the Study:
- To investigate the epidemiological differences in VRE emergence between the USA and Europe.
- To explore the role of antibiotic usage and animal reservoirs in VRE prevalence.
- To identify potential factors contributing to VRE outbreaks.
Main Methods:
- Comparative analysis of VRE epidemiology in the USA and Europe.
- Correlation of VRE emergence with antibiotic usage patterns (vancomycin, avoparcin).
- Investigation of animal reservoirs and potential virulence factors (e.g., esp gene).
Main Results:
- Higher vancomycin use in the USA correlates with ampicillin-resistant enterococci preceding VRE emergence.
- Widespread agricultural use of avoparcin in Europe explains the animal reservoir and community VRE presence.
- The variant esp gene may contribute to the pathogenicity of certain enterococcal genogroups.
Conclusions:
- Differences in antibiotic selective pressures, particularly agricultural avoparcin use in Europe, shape VRE epidemiology.
- VRE demonstrates the interconnectedness of human, animal, and global health, highlighting the spread of antibiotic resistance.
- Understanding reservoirs and transmission routes is crucial for controlling VRE spread.