ArticleAntimicrobial agents and chemotherapy2015
Vancomycin-variable enterococci can give rise to constitutive resistance during antibiotic therapy.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 66 citations in OpenAlex.
- Heteroresistance in vancomycin-variable Enterococcus faecium ST80 isolate.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Vancomycin variable Enterococci in the Netherlands (2018-2023) and the mechanism of resistance induction.PloS one · 2026Article
- Surveillance and Characterization of Vancomycin-Resistant and Vancomycin-Variable Enterococci in a Hospital Setting.Antibiotics (Basel, Switzerland) · 2025Article
- Resistance to last-resort antibiotics in enterococci.FEMS microbiology reviews · 2025Review
- Detection of vanA genes in vancomycin-susceptible Enterococcus faecium isolates: implications for additional testing.Access microbiology · 2025Article
- Prevalence and Molecular Characterization of Vancomycin VariableAnnals of laboratory medicine · 2024Article
- Fitness costs of Tn1546-type transposons harboring the vanA operon by plasmid type and structural diversity in Enterococcus faecium.Annals of clinical microbiology and antimicrobials · 2024Article
- Genetic analysis of vancomycin-variable Enterococcus faecium clinical isolates in Italy.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Integration of vanHAX downstream of a ribosomal RNA operon restores vancomycin resistance in a susceptible Enterococcus faecium strain.npj antimicrobials and resistance · 2024Article
- "Keeping us on our toes": a review of what clinicians need to know about vancomycin-variableAntimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Transiently silent acquired antimicrobial resistance: an emerging challenge in susceptibility testing.The Journal of antimicrobial chemotherapy · 2023Review
- Occult Vancomycin-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Vancomycin Resistance inMicroorganisms · 2022Review
- High prevalence of vancomycin non-susceptible and multi-drug resistant enterococci in farmed animals and fresh retail meats in Bangladesh.Veterinary research communications · 2022Article
- A Simple and Rapid Low-Cost Procedure for Detection of Vancomycin-Resistance Genes in Enterococci Reveals an Outbreak of Vancomycin-VariableDiagnostics (Basel, Switzerland) · 2022Article
- Insertion sequences and other mobile elements associated with antibiotic resistance genes inMicrobial genomics · 2022Article
- Prediction of Antimicrobial Resistance in Clinical Enterococcus faecium Isolates Using a Rules-Based Analysis of Whole-Genome Sequences.Antimicrobial agents and chemotherapy · 2022Article
- Rapid Detection of VanA/B-Producing Vancomycin-Resistant Enterococci Using Lateral Flow Immunoassay.Diagnostics (Basel, Switzerland) · 2021Article
- Alternative vanHAX promoters and increased vanA-plasmid copy number resurrect silenced glycopeptide resistance in Enterococcus faecium.The Journal of antimicrobial chemotherapy · 2021Article
- ResFinder 4.0 for predictions of phenotypes from genotypes.The Journal of antimicrobial chemotherapy · 2020Article
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
Vancomycin-resistant enterococci (VRE) are notorious clinical pathogens restricting the use of glycopeptide antibiotics in the clinic setting. Routine surveillance to detect VRE isolated from patients relies on PCR bioassays and chromogenic agar-based test methods. In recent years, we and others have reported the emergence of enterococcal strains harboring a "silent" copy of vancomycin resistance genes that confer a vancomycin-susceptible phenotype (vancomycin-susceptible enterococci [VSE]) and thus escape detection using drug sensitivity screening tests. Alarmingly, these strains are able to convert to a resistance phenotype (VSE→VRE) during antibiotic treatment, severely compromising the success of therapy. Such strains have been termed vancomycin-variable enterococci (VVE). We have investigated the molecular mechanisms leading to the restoration of resistance in VVE isolates through the whole-genome sequencing of resistant isolates, measurement of resistance gene expression, and quantification of the accumulation of drug-resistant peptidoglycan precursors. The results demonstrate that VVE strains can revert to a VRE phenotype through the constitutive expression of the vancomycin resistance cassette. This is accomplished through a variety of changes in the DNA region upstream of the resistance genes that includes both a deletion of a likely transcription inhibitory secondary structure and the introduction of a new unregulated promoter. The VSE→VRE transition of VVE can occur in patients during the course of antibiotic therapy, resulting in treatment failure. These VVE strains therefore pose a new challenge to the current regimen of diagnostic tests used for VRE detection in the clinic setting.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.