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Related Experiment Videos

High-level vancomycin-resistant enterococci causing hospital infections.

A H Uttley1, R C George, J Naidoo

  • 1Public Health Laboratory, Dulwich Hospital, London.

Epidemiology and Infection
|August 1, 1989
PubMed
Summary
This summary is machine-generated.

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High-level vancomycin resistance in enterococci has emerged in patients with renal disease. This transferable resistance, often plasmid-mediated, poses a significant threat as vancomycin is a crucial reserve antibiotic.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Nosocomial infections and colonization by vancomycin-resistant enterococci (VRE) are significant healthcare concerns.
  • Enterococci exhibiting high-level vancomycin resistance (minimal inhibitory concentrations [MICs] 64–>2000 mg/L) have been identified.
  • Patients with renal disease represent a vulnerable population for these infections.

Purpose of the Study:

  • To investigate the occurrence and characteristics of high-level vancomycin-resistant enterococci in patients with renal disease.
  • To determine the role of plasmids and conjugation in the transferability of vancomycin resistance.
  • To highlight the clinical importance of transferable VRE due to vancomycin's role as a last-resort antibiotic.

Main Methods:

Related Experiment Videos

  • Culturing and characterization of enterococcal strains from various patient samples, including blood.
  • Plasmid profiling to identify extrachromosomal DNA elements.
  • Conjugation experiments to assess the transferability of vancomycin resistance to susceptible strains.

    • Main Results:

    • Forty-one patients with renal disease were found to have nosocomial infection or colonization with high-level vancomycin-resistant enterococci.
    • Most VRE strains harbored plasmids ranging from 1.0 to 40 Megadaltons (MDa).
    • Vancomycin resistance was transferable via conjugation, though not consistently linked to plasmid presence.

    Conclusions:

    • The emergence of transferable high-level vancomycin resistance in enterococci is a critical clinical development.
    • These resistant strains, particularly in immunocompromised patients like those with renal disease, pose a substantial therapeutic challenge.
    • The findings underscore the need for vigilant surveillance and infection control measures against VRE.