ArticlePloS one2018
Prevalence of vancomycin-variable Enterococcus faecium (VVE) among vanA-positive sterile site isolates and patient factors associated with VVE bacteremia.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 42 citations in OpenAlex.
- Characterization of Vancomycin Resistance and Associated Genes in Clinical Isolates of Enterococcus Species.Cureus · 2026Article
- Vancomycin-variable enterococci as a silent reservoir of resistance: characterization of the first reported vancomycin-variableFrontiers in microbiology · 2026Article
- Surveillance and Characterization of Vancomycin-Resistant and Vancomycin-Variable Enterococci in a Hospital Setting.Antibiotics (Basel, Switzerland) · 2025Article
- Deciphering vancomycin resistance inFrontiers in microbiology · 2025Article
- Prevalence and Molecular Characterization of Vancomycin VariableAnnals of laboratory medicine · 2024Article
- Microbiological Profile of Instrumented Spinal Infections: 10-Year Study at a French Spine Center.Antibiotics (Basel, Switzerland) · 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
- Gut diversity and the resistome as biomarkers of febrile neutropenia outcome in paediatric oncology patients undergoing hematopoietic stem cell transplantation.Scientific reports · 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
- Profiling Antibiotic Susceptibility among DistinctAntibiotics (Basel, Switzerland) · 2023Article
- Article
- Using Genomics To Investigate an Outbreak of Vancomycin-Resistant Enterococcus faecium ST78 at a Large Tertiary Hospital in Queensland.Microbiology spectrum · 2023Article
- Comparison of Five Different Selective Agar for the Detection of Vancomycin-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Transiently silent acquired antimicrobial resistance: an emerging challenge in susceptibility testing.The Journal of antimicrobial chemotherapy · 2023Review
- Vancomycin Resistance inMicroorganisms · 2022Review
- Antimicrobial Susceptibility Testing for Enterococci.Journal of clinical microbiology · 2022Review
- A Simple and Rapid Low-Cost Procedure for Detection of Vancomycin-Resistance Genes in Enterococci Reveals an Outbreak of Vancomycin-VariableDiagnostics (Basel, Switzerland) · 2022Article
- Phenotypic and genotypic detection methods for antimicrobial resistance in ESKAPE pathogens (Review).Experimental and therapeutic medicine · 2022Review
- Antibiotic-resistant bacteria, antibiotic resistance genes, and antibiotic residues in wastewater from a poultry slaughterhouse after conventional and advanced treatments.Scientific reports · 2021Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vancomycin-variable enterococci (VVE) are vanA-positive, vancomycin-susceptible enterococci with the ability to revert to a vancomycin-resistant phenotype on exposure to vancomycin. We sought to assess the prevalence of VVE and to determine clinical characteristics of patients infected with VVE. We prospectively collected Enterococcus faecium sterile site isolates from Toronto Invasive Bacterial Diseases Network hospitals from January 2015 to June 2016 and calculated VVE (defined as vanA-positive, vancomycin-susceptible isolates) prevalence among vanA-containing isolates. We performed chart reviews of VVE and vancomycin-resistant E. faecium (VRE) bacteremias identified from January 2012 to June 2016, and on a random sample of patients with bacteremia due to vanA/vanB-negative, vancomycin-susceptible enterococci (VSE) from January 2015 to June 2016. Clinical characteristics were compared and factors associated with mortality assessed. Because of the potential reversion from VVE to VRE, pulsed-field gel electrophoresis (PFGE) was performed for strains causing breakthrough bacteremia in order to identify relatedness among strains with different phenotypic resistance within the same patient. VVE comprised 47% (18/38) of vanA-positive isolates. The charts of 36 VRE, 25 VVE, and 79 VSE patients were reviewed. Central venous catheter associated bacteremia was more common in VVE (44%) and VRE patients (57%) than in VSE patients (28%) (P = 0.01). The Pitt bacteremia (OR 1.3, P = 0.002) and the Charlson score (OR 1.2, P = 0.008) were the only independent mortality predictors. PFGE of strains causing breakthrough bacteremia showed high within-patient clonality, irrespective of vanA-positivity or vancomycin-susceptibility. A substantial proportion of vanA-positive isolates are VVE and are therefore not detected with conventional selective culture methods. Bacteremia sources of patients with VVE are similar to those infected with VRE. We detected no association between VVE and 30-day mortality or breakthrough bacteremia.
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