Vancomycin-resistant Enterococcus: Difference between revisions

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'''Vancomycin-resistant Enterococcus''' ('''VRE''') refers to strains of the genus ''[[Enterococcus]]'' that have acquired resistance to the antibiotic [[vancomycin]], which is often used to treat infections caused by enterococci. The emergence of VRE is a significant concern in healthcare settings due to the limited options for effective antibiotics against these resistant strains. VRE infections can range from urinary tract infections to more severe cases such as bacteremia, endocarditis, and infections of surgical sites.
{{SI}}
 
{{Infobox medical condition
| name                    = Vancomycin-resistant Enterococcus
| image                  = [[File:Vancomycin-Resistant_Enterococcus_01.jpg|250px]]
| caption                = Vancomycin-resistant ''Enterococcus'' under a microscope
| field                  = [[Infectious disease]]
| synonyms                = VRE
| symptoms                = [[Urinary tract infection]], [[bacteremia]], [[endocarditis]], [[wound infection]]
| complications          = [[Sepsis]], [[multi-organ failure]]
| onset                  =
| duration                =
| causes                  = [[Enterococcus faecium]], [[Enterococcus faecalis]]
| risks                  = [[Hospitalization]], [[antibiotic use]], [[immunocompromised]]
| diagnosis              = [[Culture (microbiology)|Culture]], [[antibiotic susceptibility testing]]
| differential            =
| prevention              = [[Infection control]], [[hand hygiene]]
| treatment              = [[Linezolid]], [[daptomycin]], [[tigecycline]]
| medication              =
| prognosis              =
| frequency              =
| deaths                  =
}}
{{Short description|Bacterial strains resistant to the antibiotic vancomycin}}
[[File:Vancomycin-from-xtal-1996-3D-balls.png|left|thumb|3D structure of vancomycin]]
[[File:Linezolid-from-xtal-2008-3D-balls.png|left|thumb|3D structure of linezolid]]
'''Vancomycin-resistant Enterococcus''' ('''VRE''') refers to strains of the [[Enterococcus]] genus of bacteria that have developed resistance to the antibiotic [[vancomycin]]. These bacteria are significant in healthcare settings due to their ability to cause infections that are difficult to treat.
==Background==
[[Enterococcus]] species are part of the normal flora of the human gastrointestinal tract but can cause serious infections, particularly in immunocompromised individuals. The development of resistance to [[vancomycin]], a last-resort antibiotic, poses a significant challenge in treating these infections.
==Mechanism of Resistance==
VRE resistance to vancomycin is primarily due to the acquisition of the [[vanA]] or [[vanB]] gene clusters, which alter the target site of the antibiotic, reducing its binding affinity. This genetic alteration is often acquired through horizontal gene transfer.
==Epidemiology==
==Epidemiology==
VRE is primarily found in the hospital environment, where the heavy use of antibiotics selects for resistant strains. The prevalence of VRE has been increasing worldwide, making it a notable pathogen in nosocomial (hospital-acquired) infections. Patients at higher risk for VRE colonization or infection include those with prolonged hospital stays, individuals receiving antibiotic therapy, patients with compromised immune systems, and those with invasive devices such as catheters or surgical drains.
VRE infections are most commonly seen in hospital settings, particularly in patients with prolonged antibiotic use, those with weakened immune systems, or those undergoing invasive procedures. The prevalence of VRE varies globally, with higher rates reported in the United States and Europe.
 
==Mechanism of Resistance==
The resistance of ''Enterococcus'' species to vancomycin is primarily due to the acquisition of genes that alter the target site of the antibiotic. The most common mechanism involves the synthesis of a modified peptidoglycan precursor with decreased affinity for vancomycin, thus preventing the antibiotic from inhibiting cell wall synthesis. These genetic changes are often mediated by mobile genetic elements, such as plasmids and transposons, which facilitate the spread of resistance genes among enterococci and other bacteria.
 
==Clinical Significance==
==Clinical Significance==
The clinical significance of VRE lies in its ability to cause difficult-to-treat infections, particularly in vulnerable patient populations. VRE infections are associated with increased morbidity, mortality, and healthcare costs. The limited treatment options for VRE infections necessitate the use of alternative antibiotics, which may be less effective, more toxic, or both.
VRE can cause a range of infections, including [[urinary tract infections]], [[bacteremia]], [[endocarditis]], and [[wound infections]]. These infections are associated with increased morbidity and mortality due to limited treatment options.
 
==Treatment==
Treatment of VRE infections often involves the use of alternative antibiotics such as [[linezolid]] or [[daptomycin]]. However, the choice of treatment depends on the site of infection and the susceptibility profile of the isolate.
==Prevention and Control==
==Prevention and Control==
Prevention and control of VRE transmission in healthcare settings involve a combination of infection control measures, including hand hygiene, the use of personal protective equipment, environmental cleaning, and the judicious use of antibiotics. Screening and isolation of colonized or infected patients may also be employed to prevent the spread of VRE.
Preventing the spread of VRE in healthcare settings involves strict adherence to infection control practices, including hand hygiene, use of personal protective equipment, and environmental cleaning. Screening and isolation of colonized or infected patients may also be necessary.
 
==See also==
==Treatment==
Treatment of VRE infections involves the use of antibiotics to which the organism is susceptible. Options may include linezolid, daptomycin, and tigecycline, among others. The choice of antibiotic depends on the site and severity of the infection, as well as the susceptibility profile of the isolate. Consultation with an infectious disease specialist is often recommended for the management of VRE infections.
 
==See Also==
* [[Antibiotic resistance]]
* [[Antibiotic resistance]]
* [[Nosocomial infection]]
* [[Enterococcus]]
* [[Infectious disease (medical specialty)|Infectious disease]]
* [[Vancomycin]]
 
==References==
[[Category:Antibiotic resistance]]
{{Reflist}}
[[Category:Antibiotic-resistant bacteria]]
[[Category:Enterococcus]]
[[Category:Enterococcus]]
[[Category:Bacterial diseases]]
{{Medicine-stub}}

Latest revision as of 00:09, 10 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Vancomycin-resistant Enterococcus
Synonyms VRE
Pronounce N/A
Specialty N/A
Symptoms Urinary tract infection, bacteremia, endocarditis, wound infection
Complications Sepsis, multi-organ failure
Onset
Duration
Types N/A
Causes Enterococcus faecium, Enterococcus faecalis
Risks Hospitalization, antibiotic use, immunocompromised
Diagnosis Culture, antibiotic susceptibility testing
Differential diagnosis
Prevention Infection control, hand hygiene
Treatment Linezolid, daptomycin, tigecycline
Medication
Prognosis
Frequency
Deaths


Bacterial strains resistant to the antibiotic vancomycin


3D structure of vancomycin
3D structure of linezolid

Vancomycin-resistant Enterococcus (VRE) refers to strains of the Enterococcus genus of bacteria that have developed resistance to the antibiotic vancomycin. These bacteria are significant in healthcare settings due to their ability to cause infections that are difficult to treat.

Background[edit]

Enterococcus species are part of the normal flora of the human gastrointestinal tract but can cause serious infections, particularly in immunocompromised individuals. The development of resistance to vancomycin, a last-resort antibiotic, poses a significant challenge in treating these infections.

Mechanism of Resistance[edit]

VRE resistance to vancomycin is primarily due to the acquisition of the vanA or vanB gene clusters, which alter the target site of the antibiotic, reducing its binding affinity. This genetic alteration is often acquired through horizontal gene transfer.

Epidemiology[edit]

VRE infections are most commonly seen in hospital settings, particularly in patients with prolonged antibiotic use, those with weakened immune systems, or those undergoing invasive procedures. The prevalence of VRE varies globally, with higher rates reported in the United States and Europe.

Clinical Significance[edit]

VRE can cause a range of infections, including urinary tract infections, bacteremia, endocarditis, and wound infections. These infections are associated with increased morbidity and mortality due to limited treatment options.

Treatment[edit]

Treatment of VRE infections often involves the use of alternative antibiotics such as linezolid or daptomycin. However, the choice of treatment depends on the site of infection and the susceptibility profile of the isolate.

Prevention and Control[edit]

Preventing the spread of VRE in healthcare settings involves strict adherence to infection control practices, including hand hygiene, use of personal protective equipment, and environmental cleaning. Screening and isolation of colonized or infected patients may also be necessary.

See also[edit]

References[edit]

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