title: Killing of VRE Enterococcus faecalis by commensal strains: Evidence for evolution and accumulation of mobile elements in the absence of competition.
abstract: Enterococci are members of the gastrointestinal tract of humans and most animals that, over the past 3 decades, have emerged as leading causes of multidrug resistant hospital acquired infection (HAI). In addition to their general hardiness, many traits have entered enterococcal lineages through horizontal gene transfer, which has led to the evolution of pathogenic hospital-associated lineages uniquely adapted for survival and proliferation in the antibiotic perturbed ecology of the gastrointestinal tract. We recently observed that the accretion of mobile genetic elements in the prototype vancomycin resistant E. faecalis, clinical isolate V583, renders it unable to co-exist with native enterococci in healthy human fecal flora. In this addendum, we discuss how these findings inform our understanding of how multidrug resistant enterococci evolve, and the implications for the development of treatments that limit colonization and spread of highly antibiotic refractory microbes of this type.
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA, USA.|b Department of Microbiology and Immunobiology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA , USA.
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Gaca
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA, USA.|b Department of Microbiology and Immunobiology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA , USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Gilmore
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics*; D000069196:Gastrointestinal Microbiome / Q000235:genetics; D041981:Gastrointestinal Tract / Q000382:microbiology; D022761:Gene Transfer, Horizontal; D006801:Humans; D020071:Interspersed Repetitive Sequences / Q000235:genetics*; D013559:Symbiosis; D020713:Vancomycin Resistance / Q000235:genetics*; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Mobile genetic elements; and colonization resistance; enterococcus; evolution; fecal flora; horizontal gene transfer; pheromone; vancomycin resistant enterococci (VRE)