Promiscuous, persistent and problematic: insights into current enterococcal genomics to guide therapeutic strategy.

Area of Science:

• Microbiology
• Genomics
• Infectious Diseases

Background:

• Vancomycin-resistant enterococci (VRE) are significant opportunistic pathogens responsible for serious infections like urinary tract infections and endocarditis.
• VRE, primarily Enterococcus faecium and E. faecalis, colonize the gastrointestinal tract and can lead to systemic dissemination.
• Hospital-associated VRE strains exhibit increased mobile genetic elements, numerous antibiotic resistance genes, and often lack functional CRISPR-Cas systems.

Purpose of the Study:

• To review current knowledge on VRE genomics.
• To discuss state-of-the-art therapeutic advances against VRE infections.

Main Methods:

• Genomic analysis of VRE isolates.
• Comparative genomics to understand dissemination routes.
• Literature review of therapeutic strategies.

Main Results:

• Genomic studies highlight VRE characteristics including increased mobile genetic elements and antibiotic resistance genes.
• Comparative genomics aids in understanding VRE transmission pathways among patients and healthcare workers.
• Declining antibiotic efficacy necessitates novel control measures.

Conclusions:

• New strategies are crucial for controlling VRE infections due to diminishing antibiotic effectiveness.
• Potential approaches include antibiotic combinations, enhancing gut microbiota resistance, and utilizing non-antibiotic agents like bacteriophages or bacteriocins.