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The rise of the Enterococcus: beyond vancomycin resistance
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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 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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Metadata
- Authors
- Arias, C. A., & Murray, B. E.
- Corresponding author
- Murray, Barbara E.
- ORCID
- 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
- PMC
- PMC3621121
- 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
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- 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
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Microbiology (medical) › 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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