Video:Vancomycin-resistant Enterococcus
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Description
Vancomycin-resistant Enterococcus, are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin.[1]VRE can spread via contact with contaminated surfaces or from person-to-person.[2]VRE infections are treated with antibiotics other than vancomycin; healthcare providers select the antibiotic based on laboratory tests.[2]
Presentation
The presentation of Vancomycin resistant Enterococcus may indicate:fever, chills, and malaise.[2][3]
Complications
Among the complications of Vancomycin-resistant Enterococcus are the following: colitis, endocarditis, osteomyelitis, sepsis and pneumonia.[4]
Risk factors
In terms of the risk factors of Vancomycin-resistant Enterococcus we find the following: individuals who are currently in the hospital(taking antibiotics for long time), as well as older individuals and individuals with weak immune systems.[5]
Mechanism
The mechanism of resistance to vancomycin found in enterococcus involves the alteration of the peptidoglycan synthesis pathway.[6]The D-alanyl-D-lactate variation results in the loss of one hydrogen-bonding interaction (four, as opposed to five for D-alanyl-D-alanine) being possible between vancomycin and the peptide. The D-alanyl-D-serine variation causes a six-fold loss of affinity between vancomycin and the peptide, likely due to steric hindrance.[7][8]
Diagnosis
Once the individual has VRE, it is important to ascertain which strain.[9] The determination is done via routine culture to narrow down the exact species and antibiotic susceptibilities.[10]
Differential diagnosis
In terms of the differential diagnosis we find that the following is looked at:bacterial sepsis, hospital-acquired infections, wound infection and infective endocarditis.[11]
Treatment
In the U.S., the medication linezolid is commonly used to treat individuals who have VRE.[12]
Epidemiology
High-level vancomycin-resistant E. faecalis and E. faecium are clinical isolates first documented in the 1980s.[13]In the United States, vancomycin-resistant E. faecium was associated with 4 percent of healthcare-associated infections reported to the Centers for Disease Control and Prevention National Healthcare Safety Network from January 2006 to October 2007.[14]
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History
In terms of history we find that the first reports of vancomycin-resistant enterococci were published in 1988 by Uttley. They documented an outbreak of vancomycin-resistant Enterococcus faecium in a hospital renal unit.[15]
References
- ↑ "Vancomycin-resistant Enterococci (VRE) in Healthcare Settings". VRE in Healthcare Settings - HAI. CDC. Archived from the original on 2019-05-18. Retrieved 2015-06-09.
- ↑ 2.0 2.1 2.2 "Vancomycin-resistant Enterococci (VRE) Basics". Vancomycin-resistant Enterococci (VRE). 28 June 2024. Archived from the original on 11 September 2024. Retrieved 10 September 2024.
- ↑ Professional Guide to Signs and Symptoms. Lippincott Williams & Wilkins. 28 March 2012. ISBN 978-1-4511-5250-0. Archived from the original on 14 September 2024. Retrieved 14 September 2024.Google books offers no page #
- ↑ Levitus, Matthew; Rewane, Ayesan; Perera, Thomas B. (2024). "Vancomycin-Resistant Enterococci". StatPearls. StatPearls Publishing.
- ↑ "Vancomycin-resistant enterococci - hospital: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 8 September 2024. Retrieved 11 September 2024.
- ↑ Arias, Cesar A.; Murray, Barbara E. (2012). "Figure 4 : The rise of the Enterococcus: beyond vancomycin resistance : Nature Reviews Microbiology". Nature Reviews Microbiology. 10 (4): 266–278. doi:10.1038/nrmicro2761. PMC 3621121. PMID 22421879.
- ↑ Meziane-Cherif, Djalal; Saul, Frederick A.; Haouz, Ahmed; Courvalin, Patrice (2012). "Structural and Functional Characterization of VanG d-Ala:d-Ser Ligase Associated with Vancomycin Resistance in Enterococcus faecalis♦". The Journal of Biological Chemistry. 287 (45): 37583–37592. doi:10.1074/jbc.M112.405522. ISSN 0021-9258. PMC 3488035. PMID 22969085.
- ↑ Coates, Anthony R. M. (2012-08-31). Antibiotic Resistance. Springer Science & Business Media. ISBN 9783642289507. Archived from the original on 2021-12-11. Retrieved 2021-11-25.
- ↑ "Vancomycin-Resistant Enterococci (VRE) Diagnosis | NIH: National Institute of Allergy and Infectious Diseases". www.niaid.nih.gov. Archived from the original on 2017-03-25. Retrieved 2017-03-24.
- ↑ Levitus, Matthew; Rewane, Ayesan; Perera, Thomas B. (2024). "Vancomycin-Resistant Enterococci". StatPearls. StatPearls Publishing. Archived from the original on 2023-05-16. Retrieved 2024-09-06.
- ↑ Said, Mina S.; Tirthani, Ekta; Lesho, Emil (2024). "Enterococcus Infections". StatPearls. StatPearls Publishing. Archived from the original on 2024-09-14. Retrieved 2024-09-14.
- ↑ Balli, Eleni P.; Venetis, Chris A.; Miyakis, Spiros (2014). "Systematic Review and Meta-Analysis of Linezolid versus Daptomycin for Treatment of Vancomycin-Resistant Enterococcal Bacteremia". Antimicrobial Agents and Chemotherapy. 58 (2): 734–739. doi:10.1128/AAC.01289-13. ISSN 0066-4804. PMC 3910884. PMID 24247127.
- ↑ Robinson, D. Ashley; Feil, Edward J.; Falush, Daniel (2010-03-16). Bacterial Population Genetics in Infectious Disease. John Wiley & Sons. ISBN 9780470600115.
- ↑ Hidron AI, Edwards JR, Patel J, et al. (November 2008). "NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007". Infect Control Hosp Epidemiol. 29 (11): 996–1011. doi:10.1086/591861. PMID 18947320.
- ↑ Gold, H. S. (15 July 2001). "Vancomycin‐Resistant Enterococci: Mechanisms and Clinical Observations". Clinical Infectious Diseases. 33 (2): 210–219. doi:10.1086/321815.