Vancomycin-resistant enterococcus

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

SEM micrograph of vancomycin-resistant enterococci.

Vancomycin-resistant enterococcus (VRE) is the name given to a group of bacterial species of the genus Enterococcus that is resistant to the antibiotic vancomycin. Enterococci are enteric and can be found in the digestive and urinary tracts of some humans. VRE was discovered in 1985[1] and are particularly dangerous to immunocompromised individuals. VRE spp. have an enhanced ability to pass resistant genes to other bacteria. While infection of healthy individuals is uncommon, it is possible that they could be colonized with newly-resistant bacteria.

There are six different types of vancomycin resistance shown by enterococci: Van-A, Van-B, Van-C, Van-D, Van-E and Van-F. Of these, only Van-A, Van-B and Van-C have been seen in general clinical practice so far. The significance is that Van-A VRE is resistant to both vancomycin and teicoplanin, Van-B VRE is resistant to vancomycin but sensitive to teicoplanin, and Van-C is only partly resistant to vancomycin, and sensitive to teicoplanin.

VRE can be carried by healthy people who have come into contact with the bacteria. The most likely place where such contact can occur is in a hospital (nosocomial infections), although it is thought that a significant percentage of intensively-farmed chicken also carries VRE.[2],[3]

In 2005, Lactobacillus rhamnosus GG (LGG), a strain of L. rhamnosus, was used successfully for the first time to treat gastrointestinal carriage of VRE in renal patients.[4]

See also


  1. Dixson S, Brumfitt W, Hamilton-Miller JM (1985). "In vitro activity of six antibiotics against multiresistant staphylococci and other gram-positive cocci". Eur J Clin Microbiol. 4 (1): 19–23. PMID 3157567.
  2. Harwood VJ, Brownell M, Perusek W, Whitlock JE (2001). "Vancomycin-resistant Enterococcus spp. isolated from wastewater and chicken feces in the United States". Appl Environ Microbiol. 67 (10): 4930–3. PMID 11571206.
  3. Cox LA Jr, Popken DA (2004). "Quantifying human health risks from virginiamycin used in chickens". Risk Anal. 24 (1): 271–88. PMID 15028017.
  4. Manley KJ, Fraenkel MB, Mayall BC, Power DA (2007). "Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial". Med J Aust. 186 (9): 454–7. PMID 17484706.

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