title: Emergence and spread of vancomycin resistance among enterococci in Europe.
abstract: Nowadays, six types of acquired vancomycin resistance in enterococci are known; however, only VanA and to a lesser extent VanB are widely prevalent. Various genes encode acquired vancomycin resistance and these are typically associated with mobile genetic elements which allow resistance to spread clonally and laterally. The major reservoir of acquired vancomycin resistance is Enterococcus faecium; vancomycin-resistant Enterococcus faecalis are still rare. Population analysis of E. faecium has revealed a distinct subpopulation of hospital-acquired strain types, which can be differentiated by molecular typing methods (MLVA, MLST) from human commensal and animal strains. Hospital-acquired E. faecium have additional genomic content (accessory genome) including several factors known or supposed to be virulence-associated. Acquired ampicillin resistance is a major phenotypic marker of hospital-acquired E. faecium in Europe and experience has shown that it often precedes increasing rates of VRE with a delay of several years. Several factors are known to promote VRE colonisation and transmission; however, despite having populations with similar predispositions and preconditions, rates of VRE vary all over Europe.
authors.affiliation: Robert Koch-Institute, Wernigerode Branch, Wernigerode, Germany. wernerg@rki.de
authors.forename: G
authors.initials: G
authors.lastname: Werner
authors.forename: T M
authors.initials: TM
authors.lastname: Coque
authors.forename: A M
authors.initials: AM
authors.lastname: Hammerum
authors.forename: R
authors.initials: R
authors.lastname: Hope
authors.forename: W
authors.initials: W
authors.lastname: Hryniewicz
authors.forename: A
authors.initials: A
authors.lastname: Johnson
authors.forename: I
authors.initials: I
authors.lastname: Klare
authors.forename: K G
authors.initials: KG
authors.lastname: Kristinsson
authors.forename: R
authors.initials: R
authors.lastname: Leclercq
authors.forename: C H
authors.initials: CH
authors.lastname: Lester
authors.forename: M
authors.initials: M
authors.lastname: Lillie
authors.forename: C
authors.initials: C
authors.lastname: Novais
authors.forename: B
authors.initials: B
authors.lastname: Olsson-Liljequist
authors.forename: L V
authors.initials: LV
authors.lastname: Peixe
authors.forename: E
authors.initials: E
authors.lastname: Sadowy
authors.forename: G S
authors.initials: GS
authors.lastname: Simonsen
authors.forename: J
authors.initials: J
authors.lastname: Top
authors.forename: J
authors.initials: J
authors.lastname: Vuopio-Varkila
authors.forename: R J
authors.initials: RJ
authors.lastname: Willems
authors.forename: W
authors.initials: W
authors.lastname: Witte
authors.forename: N
authors.initials: N
authors.lastname: Woodford
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects*; D005060:Europe / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D011159:Population Surveillance; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D014640:Vancomycin