Cited by 1,776Antibiotic Resistance in BacteriaAntimicrobial Resistance in StaphylococcusInfections and bacterial resistance

The rise of the Enterococcus: beyond vancomycin resistance

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Arias, Cesar A., Murray, Barbara E.·2012·Nature Reviews Microbiology

Abstract

The genus Enterococcus includes some of the most important nosocomial multidrug-resistant organisms, and these pathogens usually affect patients who are debilitated by other, concurrent illnesses and undergoing prolonged hospitalization. This Review discusses the factors involved in the changing epidemiology of enterococcal infections, with an emphasis on Enterococcus faecium as an emergent and challenging nosocomial problem. The effects of antibiotics on the gut microbiota and on colonization with vancomycin-resistant enterococci are highlighted, including how enterococci benefit from the antibiotic-mediated eradication of gram-negative members of the gut microbiota. Analyses of enterococcal genomes indicate that there are certain genetic lineages, including an E. faecium clade of ancient origin, with the ability to succeed in the hospital environment, and the possible virulence determinants that are found in these genetic lineages are discussed. Finally, we review the most important mechanisms of resistance to the antibiotics that are used to treat vancomycin-resistant enterococci.

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  • Vancomycin resistance is especially relevant in enterococci, particularly E. faecium, and is usually accompanied by other resistance determinants, making treatment of infections caused by these organisms an important clinical challenge.

    “Vancomycin resistance is especially relevant in enterococci (particularly E. faecium) and it is usually accompanied by the presence of other resistance determinants, making the treatment of infections caused by these organisms an important clinical challenge (73).”

    From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [73]

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Authors
Arias, C. A., & Murray, B. E.
Corresponding author
Murray, Barbara E.
Venue
Nature Reviews Microbiology
Published
2012-03-16
Volume
10
Issue
4
Pages
266-278
ISSN
  • 1740-1526 (ISSN-L)
  • 1740-1534
OpenAlex
W1976667730
Cited by
1,776
References
154
Citations by year
2026: 160 · 2025: 147 · 2024: 140 · 2023: 132 · 2022: 163 · 2021: 122 · 2020: 143 · 2019: 133 · 2018: 117 · 2017: 110 · 2016: 104 · 2015: 95 · 2014: 114 · 2013: 75 · 2012: 19
FWCI
5.68
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Microbiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion)
Funders
National Institute of Allergy and Infectious Diseases (R00 AI72961, R37AI47923, R37AI047923, R01AI093749, R00AI072961, R01AI067861)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
Keywords
Enterococcus, Enterococcus faecium, vancomycin resistance, nosocomial infections, multidrug resistance, gut microbiota, antibiotic-induced dysbiosis, genetic lineages, antibiotic resistance mechanisms
MeSH terms
Animals, Anti-Bacterial Agents, Bacterial Proteins, Cross Infection, Enteritis, Humans, Vancomycin, Gram-Positive Bacterial Infections, Enterococcus faecium, Vancomycin Resistance, Drug Resistance, Multiple, Bacterial, Virulence Factors, Gastrointestinal Tract, Microbial Interactions

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