Vancomycin-resistant enterococci VRE

Problems of recent years involving listeriosis, salmonellosis, giardiasis and Legionnaire s disease have received attention, as have the re-emergence of tuberculosis and the importance of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). 

If the isolate is determined to be vancomycin-resistant, it is most important to know the exact species because some of the treatment options, such as quinupristin/dalfopristin, are not active against E. faecalis. Currently, the treatment options for vancomycin-resistant enterococci (VRE) are not well established by clinical studies or patient experience. The treatment recommendations for vancomycin-resistant E. faecium include linezolid or quinupristin/dalfopristin for a minimum of 8 weeks. However, newer agents, such as daptomycin, may provide another option for treatment for either enterococci species (E. faecium and E. faecalis). Additionally, guidelines suggest the use of imipenem-cilistatin plus ampicillin or ceftriaxone plus ampicillin for the treatment of E. faecalis with a minimum of 8 weeks of therapy. Consultation with an infectious diseases specialist is recommended. 

The combined synergistic effects of cyclo(Leu-Pro) and cyclo(Phe-Pro) were effective against five vancomycin-resistant enterococci (VRE) strains Enterococcus faecium (K-99-38), E. faecalis (K-99-17), E. faecalis (K-99-258), E. faecium (K-01-312), and E. faecalis (K-01-511) with MIC values of 0.25—1 mgl . It also showed activity against E. coli, Staphylococcus aureus. Micrococcus luteus, Candida albicans, and Cryptococcus neoformans with MIC values of 0.25—0.5 mg 1. This combination also showed mutagenic activity against Salmonella typhimurium TA98 and TAIOO strains in a Salmonella mutation assay. ... 

B) Seek the newly approved drug linezolid for possibility of vancomycin-resistant enterococci (VRE)... 

Sakagami, Y., linuma, M., Piyasena, K.C.N.P. and Dharmaratne, H.R.W. (2005) Antibacterial activity of a-mangostin against vancomycin resistant Enterococci VRE) and synergism with antibiotics. Phytomedicine 12(3), 203-208. 

Daptomycin has proven efficacy in a number of in vivo animal models, including soft tissue infections by MRSA, bacteraemia caused by S. aureus or vancomycin-resistant enterococci (VRE), Enterococcus faecalis pyelonephritis, MRSA osteomyelitis, MRSA and Bacillus anthracis pulmonary infections, Gram-positive endocarditis, Clostridium difficile colitis and S. pneumoniae and S. aureus meningitis.9,64 66... 

Problems of cmtimicrobial resistance have burgeoned during the past decade in most coimtries of the world. Some resistant microbes are currently mainly restricted to patients in the hospitcil, e.g. MRSA, vancomycin-resistant enterococci (VRE), and coliforms that produce extended spectrum P-lactamases. Others more commonly infect patients in the community e.g. penicillin-resistant Streptococcus pneumoniae and multiply-resistant Mycobacterium tuberculosis. Evidence is accruing that the outcomes of infections with antibiotic resistant bacteria are generally poorer than those with... 

Vancomycin is a glycopeptide antibiotic that is very important in human medicine because of its activity against multidrug-resistant organisms such as MRSA and enterococci. Vancomycin is only active against Gram-positive bacteria. In recent years, nosocomial infections of vancomycin-resistant enterococci (VRE) have become a major problem in human hospitals. Recently, a MRSA... 

Garcinia kola Heckel (roots) GB-flavones ((I-3,II-8)-Jlavanone-flavone Garcinianin atropisomers (166) GBi (176) GB2 (177) kolaflavanone (178) manniflavanone (179) garciniflavanone (180). GBi showed antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Iwu et al., 1990b Terashima et al., 1995[195], 1999[196] Han et al.,2005[74]. 

The role of enterococci in nosocomial infections is probably due to a variety of factors of which antimicrobial resistance appears to be a primary cause. Enterococci possess a broad spectrum of both natural (intrinsic) resistance and acquired (transferable) resistance (Franz et al. 2003). Examples of antibiotics to which the enterococci present an intrinsic resistance include the P-lactam antibiotics (third generation cephalosporins), sulphonamides and clindamycin and aminoglycosides in low levels (Eranz et al. 2003). Acquired resistance based on plasmids or transpo-sons acquisition has relevance for chloramphenicol, erythromycin, high levels of clindamycin, aminoglycosides, tetracycline, high levels of P-lactam antibiotics, fluoroquinolones and glycopeptides like vancomycin (Murray 1990 Leclercq 1997). In particular, vancomycin-resistant enterococci (VRE) pose a major problem... 

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