Vancomycin-Resistant Enterococci : Therapeutic Challenges in the 21st Century - 20/05/16

Doi : 10.1016/j.idc.2016.02.006

William R. Miller, MD ^a, Barbara E. Murray, MD ^a,^b, Louis B. Rice, MD ^c, Cesar A. Arias, MD, MSc, PhD ^a,^b,^d,^⁎
^a Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA
^b Department of Microbiology and Molecular Genetics, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA
^c Departments of Medicine, Microbiology and Immunology, Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903, USA
^d Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Avenue Cra 9 No. 131 A - 02, Bogotá, Colombia

^∗Corresponding author. University of Texas Medical School, 6431 Fannin Street, Room MSB 2.112, Houston, TX 77030.University of Texas Medical School6431 Fannin StreetRoom MSB 2.112HoustonTX77030

Résumé

Vancomycin-resistant enterococci are serious health threats due in part to their ability to persist in rugged environments and their propensity to acquire antibiotic resistance determinants. Enterococci have now established a home in our hospitals and possess mechanisms to defeat most currently available antimicrobials. This article reviews the history of the struggle with this pathogen, what is known about the traits associated with its rise in the modern medical environment, and the current understanding of therapeutic approaches in severe infections caused by these microorganisms. As the 21st century progresses, vancomycin-resistant enterococci continue to pose a daunting clinical challenge.

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Keywords : Vancomycin resistant enterococcus, Antibiotic resistance, Combination therapy

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Disclosure Statement: Dr W.R. Miller has no relevant affiliations or financial disclosures. Dr B.E. Murray has grant support from Johnson & Johnson, Astellas, Palumed, Intercell and Cubist, and has served as consultant for Astellas (Theravance), Cubist, Targanta Therapeutics Corporation, Pfizer, Rib-X, AstraZeneca and Durata Therapeutics. Dr L.B. Rice has served as a consultant for Astra-Zeneca, Tetraphase Pharmaceuticals, MicuRx, Macrolide Pharmaceuticals and Adenium Pharmaceuticals. Dr C.A. Arias has received lecture fees, research support and consulting fees from Theravance, Bayer and Cubist; research support from Forrest Pharmaceuticals and Theravance Inc and has served as speaker for Forest, Theravance, Pfizer, Astra-Zeneca, Cubist, The Medicines Company and Norvartis.

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Vol 30 - N° 2

P. 415-439 - juin 2016 Retour au numéro

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Vancomycin-Resistant Enterococci : Therapeutic Challenges in the 21st Century - 20/05/16

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