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Related Experiment Videos

Constitutively vancomycin-resistant Enterococcus faecium resistant to synergistic beta-lactam combinations

M Green1, B Binczewski, A W Pasculle

  • 1Department of Medicine, Children's Hospital of Pittsburgh, Pennsylvania.

Antimicrobial Agents and Chemotherapy
|June 1, 1993
PubMed
Summary

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Vancomycin resistance in Enterococcus faecium presents unique challenges. Some strains show high-level resistance, but the exact genetic mechanism for this constitutive resistance remains unclear, impacting treatment strategies.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Vancomycin resistance in enterococci is an emerging clinical concern.
  • Synergy between vancomycin and penicillin is documented for some resistant Enterococcus faecium isolates.
  • Unique phenotypic characteristics of vancomycin-resistant E. faecium warrant further investigation.

Purpose of the Study:

  • To characterize three unique isolates of vancomycin-resistant Enterococcus faecium.
  • To investigate the mechanism of constitutive resistance in these isolates.
  • To evaluate the potential for synergistic therapy with vancomycin and penicillin.

Main Methods:

  • Phenotypic characterization of antibiotic resistance.
  • Inducibility and curability of resistance assays.

Related Experiment Videos

  • Mating experiments for resistance transfer.
  • Antibiotic susceptibility testing (MIC determination).
  • Immunoblotting and nucleic acid hybridization techniques.

    • Main Results:

    • Three E. faecium isolates displayed high-level vancomycin and teicoplanin resistance (VanA phenotype).
    • Resistance was constitutive, not inducible or transferable via conjugation.
    • Vancomycin-penicillin combination did not significantly alter penicillin MICs.
    • Hybridization studies indicated vanA gene on chromosomal DNA, not plasmids.
    • No reaction observed with anti-VanB antibody.

    Conclusions:

    • The mechanism of constitutive vancomycin resistance in these E. faecium isolates is unclear.
    • A secondary mutation, potentially involving PBP 5, may contribute to resistance.
    • In vitro testing of vancomycin-penicillin combinations is crucial for clinical consideration.