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Updated: Jul 9, 2026
11:56
Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
Published on: October 25, 2013
Optimizing therapy for vancomycin-resistant enterococci (VRE)
1Department of Critical Care Medicine, University of Pittsburgh Medical Center, 3550 Terrace Street, Pittsburgh, PA 15261, USA. lindenpk@ccm.upmc.edu
Seminars in Respiratory and Critical Care Medicine
|December 21, 2007
Summary
Hospital-acquired enterococcal infections are rising due to multidrug-resistant strains. New treatments are emerging, but resistance is a growing concern, necessitating careful antimicrobial stewardship and non-antimicrobial interventions.
Area of Science:
- Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Enterococci are gram-positive bacteria causing various infections, with a significant rise in hospital-acquired infections over two decades.
- Multidrug-resistant enterococcal strains are increasingly prevalent due to acquired resistance determinants.
- Accurate interpretation of enterococcal cultures is crucial to prevent unnecessary antimicrobial therapy.
Purpose of the Study:
- To review the current landscape of enterococcal infections, focusing on antimicrobial resistance.
- To discuss traditional and novel antimicrobial agents for treating enterococcal infections, including vancomycin-resistant enterococci (VRE).
- To highlight the challenges in treating complex infections like VRE endocarditis and the role of non-antimicrobial measures.
Main Methods:
- Literature review of enterococcal infections, antimicrobial resistance patterns, and treatment strategies.
- Analysis of traditional and novel antimicrobial agents, including their efficacy and resistance profiles.
- Examination of clinical trial data and treatment guidelines for enterococcal infections.
Main Results:
- Traditional therapies remain effective for susceptible strains, but multidrug resistance is a significant challenge.
- Novel agents like linezolid, quinupristin-dalfopristin, daptomycin, and tigecycline have been developed for resistant strains.
- Emerging resistance to newer agents (quinupristin-dalfopristin, linezolid, daptomycin, tigecycline) is a growing concern.
- Optimal treatment for VRE endocarditis is not well-defined, with most agents providing bacteriostasis.
Conclusions:
- Linezolid is a cornerstone for VRE treatment, but resistance is emerging.
- Non-antimicrobial interventions, such as foreign body removal and infection source control, are vital.
- Careful clinical interpretation and judicious use of antimicrobials are paramount to combatting enterococcal resistance.
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