title: Vancomycin-Variable Enterococcal Bacteremia.
abstract: Vancomycin-variable enterococcus (VVE) is an emerging pathogen. VVE isolates initially appear phenotypically susceptible to vancomycin but possesses the vanA gene and can develop in vitro and in vivo resistance to vancomycin. We report a case of VVE bacteremia and describe how VVE poses diagnostic and therapeutic dilemmas.
authors.affiliation: St. Joseph's Health Centre, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: Downing
authors.affiliation: St. Joseph's Health Centre, Toronto, ON, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Eshaghi
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada Mount Sinai Hospital, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: McGeer
authors.affiliation: Public Health Ontario, Toronto, ON, Canada Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
authors.forename: S N
authors.initials: SN
authors.lastname: Patel
authors.affiliation: St. Joseph's Health Centre, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Public Health Ontario, Toronto, ON, Canada jennie.johnstone@oahpp.ca.
authors.forename: J
authors.initials: J
authors.lastname: Johnstone
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology*; D001426:Bacterial Proteins / Q000235:genetics; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D016983:Enterococcus / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases