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Vancomycin-resistant enterococci: clinical, microbiologic, and epidemiologic features
1Department of Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
Abstract:
Enterococci have emerged as important nosocomial pathogens with increasing antimicrobial resistance. Within the past 5 years, vancomycin-resistant strains have disseminated throughout the United States and Europe. Many of these organisms are also highly resistant to beta-lactams and aminoglycosides, making them virtually untreatable. Because optimal therapy for these infections is unknown, attributable mortality rates for patients with vancomycin-resistant enterococcal bacteremia are extremely high. Recently identified risk factors for acquisition include prolonged hospitalization, prior antibiotic use, and serious underlying illness. Until effective therapy is available, prevention of infection by proper infection control procedures and judicious antibiotic use is critical.
Insights
Vancomycin-resistant enterococci are a growing threat in hospitals, often resistant to multiple antibiotics. High mortality rates underscore the urgent need for effective treatments and prevention strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Enterococci are significant nosocomial pathogens.
- Increasing antimicrobial resistance, particularly vancomycin resistance, is a major concern.
- Dissemination of vancomycin-resistant enterococci (VRE) across the US and Europe is documented.
Purpose of the Study:
- To highlight the clinical significance of vancomycin-resistant enterococci.
- To discuss the challenges in treating VRE infections due to multidrug resistance.
- To emphasize the high mortality associated with VRE bacteremia.
Main Methods:
- Review of current literature on enterococcal infections.
- Analysis of trends in antimicrobial resistance.
- Identification of risk factors for VRE acquisition.
Main Results:
- VRE strains exhibit resistance to beta-lactams and aminoglycosides, complicating treatment.
- Optimal therapeutic strategies for VRE infections remain undefined.
- Attributable mortality for VRE bacteremia is notably high.
Conclusions:
- Prevention through infection control and judicious antibiotic use is critical.
- Urgent need for development of effective therapies against VRE.
- Risk factors such as prolonged hospitalization and prior antibiotic exposure are identified.