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Related Experiment Videos

Vancomycin-dependent Enterococcus faecium isolated from stool following oral vancomycin therapy

L L Dever1, S M Smith, S Handwerger

  • 1Infectious Diseases Section, Veterans Affairs Medical Center, East Orange, New Jersey 07018, USA.

Journal of Clinical Microbiology
|October 1, 1995
PubMed
Summary

A novel strain of vancomycin-dependent Enterococcus faecium was isolated from a patient. This vancomycin-dependent enterococci strain evolved from vancomycin-resistant bacteria under vancomycin pressure.

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Area of Science:

  • Microbiology
  • Antimicrobial Resistance

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
  • Emergence of vancomycin resistance in enterococci poses a significant clinical challenge.
  • Vancomycin-dependent enterococci are rarely reported clinical isolates.

Observation:

  • A patient who completed vancomycin therapy yielded vancomycin-dependent Enterococcus faecium in stool.
  • This vancomycin-dependent E. faecium strain grew with ristocetin and D-alanyl-D-alanine.
  • Spontaneous vancomycin-independent revertants emerged at a rate of 10^-6.

Findings:

  • Both vancomycin-dependent E. faecium and revertants contained the vanB gene.
  • Identical contour-clamped homogeneous electrophoresis patterns were observed for both strains.

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  • Revertant colonies predominantly exhibited teicoplanin resistance, indicating constitutive vanB ligase production.

    • Implications:

    • Vancomycin-dependent enterococci may evolve from vancomycin-resistant strains under selective antibiotic pressure.
    • Understanding the mechanisms of vancomycin dependence is crucial for infection control.
    • This finding highlights the adaptability of enterococci in response to antimicrobial therapy.