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Enterococcus faecium has been a leading cause of multi-drug resistant enterococcal infections over Enterococcus faecalis in the United States. Approximately 40% of medical intensive care units reportedly found that the majority, respectively 80% and 90.4%, of device-associated infections (namely, infections due to central lines, urinary drainage catheters, and ventilators) were due to ...
Vancomycin. Six different types of vancomycin resistance are shown by enterococcus: Van-A, Van-B, Van-C, Van-D, Van-E and Van-G. [4] The significance is that Van-A VRE is resistant to both vancomycin and teicoplanin, [5] Van-B VRE is resistant to vancomycin but susceptible to teicoplanin, [6] [7] and Van-C is only partly resistant to vancomycin.
There are also strains of enterococci that have developed resistance to vancomycin referred to as vancomycin resistant enterococcus (VRE). Agents classified as fourth-line (or greater) treatments or experimental therapies could be considered by default to be drugs of last resort due to their low placement in the treatment hierarchy.
The antibiotic, rifaximin, has enabled the global emergence of vancomycin-resistant enterococcus faecium, or VRE, a superbug that frequently causes serious infections in hospitalised patients ...
Quinupristin and dalfopristin are protein synthesis inhibitors in a synergistic manner. While each of the two is only a bacteriostatic agent, the combination shows bactericidal activity.
Resistance to vancomycin in E. faecalis is becoming more common. [18] [19] Treatment options for vancomycin-resistant E. faecalis include nitrofurantoin (in the case of uncomplicated UTIs), [20] linezolid, quinupristin, tigecycline [17] and daptomycin, although ampicillin is preferred if the bacteria are susceptible. [21]
In catheterized patients receiving intensive care, Enterococcus spp., have been reported the dominant cause of urinary tract infections, particularly in patients treated with cephalosporin antibiotics. [11] Urinary tract infections can be treated specifically with nitrofurantoin, even in cases of vancomycin resistance. [12]
As of 2017, point-of-care resistance diagnostics were available for methicillin-resistant Staphylococcus aureus (MRSA), rifampin-resistant Mycobacterium tuberculosis (TB), and vancomycin-resistant enterococci (VRE) through GeneXpert by molecular diagnostics company Cepheid. [41]
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