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Updated: Jul 9, 2026

Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
11:56

Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection

Published on: October 25, 2013

Optimizing therapy for vancomycin-resistant enterococci (VRE).

Peter K Linden1

  • 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
PubMed
Summary
This summary is machine-generated.

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.

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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.