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Vancomycin-resistant enterococci: colonization, infection, detection, and treatment
1Division of General internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Abstract:
Vancomycin-resistant enterococci (VRE) are becoming a major concern in medical practice. Their increased prevalence and their ability to transfer vancomycin resistance to other bacteria (including methicillin-resistant Staphylococcus aureus) have made them a subject of close scrutiny and intense investigation. Colonization is usually acquired by susceptible hosts in an environment with a high rate of patient colonization with VRE (eg, intensive care units, oncology units). Vancomycin-resistant enterococci can survive in the environment for prolonged periods (>1 week), can contaminate almost any surface, and can be passed from one patient to another by health care workers. Whether VRE colonization leads to infection depends on the health status of the patient. Whereas immunocompetent patients colonized with VRE are at low risk for infection, weakened hosts (patients with hematologic disorders, transplant recipients, or severely ill patients) have an increased likelihood of developing infection following colonization. Quinupristin-dalfopristin and linezolid are among the anti-infective agents that have recently become available to treat infection caused by VRE. Other antimicrobials are currently under development. Molecular techniques such as polymerase chain reaction and standard culture studies are being used to detect VRE colonization, infection, and outbreaks.
Insights
Vancomycin-resistant enterococci (VRE) pose a significant threat due to their persistence and ability to spread resistance. Vulnerable patients are at higher risk of VRE infection, necessitating advanced detection and treatment strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Vancomycin-resistant enterococci (VRE) represent a growing global health concern.
- VRE's ability to transfer resistance genes to other pathogens, like MRSA, heightens its clinical significance.
- Environmental persistence and transmission by healthcare workers facilitate VRE colonization in healthcare settings.
Purpose of the Study:
- To review the epidemiology, transmission, and clinical implications of Vancomycin-resistant enterococci (VRE).
- To discuss current and emerging therapeutic options for VRE infections.
- To highlight diagnostic methods for VRE detection.
Main Methods:
- Literature review of VRE epidemiology, transmission dynamics, and clinical outcomes.
- Analysis of antimicrobial resistance patterns and treatment efficacy.
- Evaluation of molecular and culture-based diagnostic techniques.
Main Results:
- VRE colonization is common in high-risk units (ICUs, oncology) and can lead to infection, particularly in immunocompromised patients.
- VRE can survive on surfaces for extended periods, increasing transmission risk.
- New agents like quinupristin-dalfopristin and linezolid are available for VRE treatment, with others in development.
Conclusions:
- VRE infections are a serious challenge, especially for vulnerable patient populations.
- Effective infection control and timely diagnosis are crucial for managing VRE.
- Ongoing research into novel antimicrobials and diagnostics is essential to combat VRE.
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