The DOI matches its Crossref record; 102 of the 104 references it cites were found in a registry or an index.
Vancomycin-resistant enterococci: why are they here, and where do they come from?
Abstract
Vancomcyin-resistant enterococci (VRE) have emerged as nosocomial pathogens in the past 10 years, causing epidemiological controversy. In the USA, colonisation with VRE is endemic in many hospitals and increasingly causes infection, but colonisation is absent in healthy people. In Europe, outbreaks still happen sporadically, usually with few serious infections, but colonisation seems to be endemic in healthy people and farm animals. Vancomycin use has been much higher in the USA, where emergence of ampicillin-resistant enterococci preceded emergence of VRE, making them very susceptible to the selective effects of antibiotics. In Europe, avoparcin, a vancomycin-like glycopeptide, has been widely used in the agricultural industry, explaining the community reservoir in European animals. Avoparcin has not been used in the USA, which is consistent with the absence of colonisation in healthy people. From the European animal reservoir, VRE and resistance genes have spread to healthy human beings and hospitalised patients. However, certain genogroups of enterococci in both continents seem to be more capable of causing hospital outbreaks, perhaps because of the presence of a specific virulence factor, the variant esp gene. By contrast with the evidence of a direct link between European animal and human reservoirs, the origin of American resistance genes remains to be established. Considering the spread of antibiotic-resistant bacteria and resistance genes, the emergence of VRE has emphasised the non-existence of boundaries between hospitals, between people and animals, between countries, and probably between continents.
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“This disturbance can lead to the growth and expansion of pathogens within the intestine (including antibiotic-resistant pathogens), where these pathogens can exploit the absence of competitors and the nutrient-enriched gut environment.”
From Role of the gut microbiota in nutrient competition and protection against intestinal pathogen colonization (2023) · cites this paper as [30]
In the citing paper
“This promotes intestinal colonization (and even domination) by pathogens such as Clostridioides difficile , carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococcus (VRE) [30–32].”
From Role of the gut microbiota in nutrient competition and protection against intestinal pathogen colonization (2023) · cites this paper as [30]
In the citing paper
“Antibiotic treatment – especially treatment with broad-spectrum antibiotics – kills members of the gut microbiota and disrupts colonization resistance (Fig. 1).”
From Role of the gut microbiota in nutrient competition and protection against intestinal pathogen colonization (2023) · cites this paper as [30]
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Self-citation
Metadata
- Authors
- Bonten, M. J., Willems, R., & Weinstein, R. A.
- Affiliations
- University Medical Center Utrecht (NL)
- National Institute for Public Health and the Environment (NL)
- John H. Stroger, Jr. Hospital of Cook County (US)
- Corresponding author
- Bonten, Marc JM
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2001-12
- Volume
- 1
- Issue
- 5
- Pages
- 314-325
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W1998796942
- Cited by
- 400
- References
- 104
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 10 · 2023: 17 · 2022: 6 · 2021: 10 · 2020: 17 · 2019: 12 · 2018: 14 · 2017: 18 · 2016: 17 · 2015: 11 · 2014: 18 · 2013: 28 · 2012: 25
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Keywords
- vancomycin-resistant enterococci, nosocomial infections, antibiotic resistance, avoparcin, reservoir hosts, human colonization, hospital outbreak, virulence genes, esp gene, resistance gene spread, antimicrobial use
- MeSH terms
- Animals, Animal Husbandry, Anti-Bacterial Agents, Bacterial Proteins, Cross Infection, Disease Outbreaks, Europe, Humans, Membrane Proteins, North America, Vancomycin, Gram-Positive Bacterial Infections, Enterococcus, Enterococcus faecium, Infection Control, Vancomycin Resistance
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