D-Ala-D-Ala ligases from glycopeptide antibiotic-producing organisms are highly homologous to the enterococcal vancomycin-resistance ligases VanA and VanB

Antibiotic resistance has become a major world health challenge and has limited the ability of physician's treatment. Staphylococcus aureus the most notorious pathogens causes morbidity and mortality especially in burn patients. However, Staphylococcus aureus rapidly acquired resistance to multiple antibiotics. Vancomycin, a glycopeptide antibiotic remains a drug of choice for treatment of severe Methicillin Resistance S. aureus infections. This study aimed to detect the emergence of beta-lactam and glycopeptide resistance genes. 50 clinical specimens of S. aureus collected from burn patients in burn and plastic surgery units in Sulaimani-Iraq city. All specimens were confirmed to be positive for S. aureus. All the isolates were assessed for their susceptibility to different antibiotics depending on NCCL standards, followed by Extended Spectrum Beta Lactamase detection by double disk diffusion synergy test. The production of β- lactamases was evaluated in the isolated strains by several routine methods and polymerase chain reaction. Among the isolates 94% were Methicillin resistance and 34.28% were Extended Spectrum Beta Lactamase producer. PCR based molecular technique was done for the bla genes related to β- lactamase enzymes by the specific primers, as well as genes which related to reduced sensitivity to Vancomycin were detected. The results indicated that all isolated showed the PBP1, PBP2, PBP3, PBP4, trfA and trfB, graSR, vraS except the vraR gene and the prolonged therapy of Methicillin resistance infection with teicoplanin have been associated with progress of resistance and the rise of tecoplanin resistance may be a prologue to evolving Vancomycin resistance. In conclusion, beta-lactam over taking can rise Vancomycin- Intermediate S. aureus strains leading to appearance of Vancomycin resistance although the treatment of Vancomycin resistant infections is challenging.

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CLINICAL CHARACTERISTICS AND THE IMPACT OF VANCOMYCIN-RESISTANCE ON THE OUTCOMES IN ENTEROCOCCAL BACTEREMIA DIAGNOSED IN FEBRILE NEUTROPENIC CHILDREN

10.26226/morressier.58fa1768d462b80290b50b89 ◽

2017 ◽

Author(s):

Seung Beom Han

Keyword(s):

Clinical Characteristics ◽

Vancomycin Resistance ◽

The Impact ◽

Enterococcal Bacteremia

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Faculty Opinions recommendation of Lack of relationship between purine biosynthesis and vancomycin resistance in Staphylococcus aureus: a cautionary tale for microarray interpretation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1061893.513842 ◽

2007 ◽

Author(s):

Harald Labischinski

Keyword(s):

Staphylococcus Aureus ◽

Vancomycin Resistance ◽

Purine Biosynthesis ◽

Cautionary Tale

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Pharmacokinetic-Pharmacodynamic Modeling of Dalbavancin, a Novel Glycopeptide Antibiotic

The Journal of Clinical Pharmacology ◽

10.1177/0091270008321273 ◽

2008 ◽

Vol 48 (9) ◽

pp. 1063-1068 ◽

Cited By ~ 33

Author(s):

James A. Dowell ◽

Beth P. Goldstein ◽

Mary Buckwalter ◽

Martin Stogniew ◽

Bharat Damle

Keyword(s):

Pharmacodynamic Modeling ◽

Glycopeptide Antibiotic

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Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽

10.3390/antibiotics10020105 ◽

2021 ◽

Vol 10 (2) ◽

pp. 105

Author(s):

Jatapat Hemapanpairoa ◽

Dhitiwat Changpradub ◽

Sudaluck Thunyaharn ◽

Wichai Santimaleeworagun

Keyword(s):

Risk Factors ◽

Clinical Outcomes ◽

Proportional Hazards Model ◽

Significant Risk ◽

Vancomycin Resistance ◽

Cox Proportional Hazards Model ◽

Factors Associated ◽

Joint Infections ◽

Bone And Joint Infections ◽

The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

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Attributable mortality of vancomycin resistance in ampicillin-resistant Enterococcus faecium bacteremia in Denmark and the Netherlands: A matched cohort study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.216 ◽

2021 ◽

pp. 1-9

Author(s):

Wouter C. Rottier ◽

Mette Pinholt ◽

Akke K. van der Bij ◽

Magnus Arpi ◽

Sybrandus N. Blank ◽

...

Keyword(s):

Cohort Study ◽

The Netherlands ◽

Antibiotic Therapy ◽

Enterococcus Faecium ◽

Mortality Rates ◽

Vancomycin Resistance ◽

Attributable Mortality ◽

Matched Cohort ◽

Matched Cohort Study ◽

The Impact

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

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Vancomycin resistance: are there better glycopeptides coming?

Expert Review of Anti-infective Therapy ◽

10.1586/14787210.6.6.917 ◽

2008 ◽

Vol 6 (6) ◽

pp. 917-928 ◽

Cited By ~ 15

Author(s):

Peter K Linden

Keyword(s):

Vancomycin Resistance

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More than just recruitment: the X-domain influences catalysis of the first phenolic coupling reaction in A47934 biosynthesis by Cytochrome P450 StaH

Molecular BioSystems ◽

10.1039/c6mb00373g ◽

2016 ◽

Vol 12 (10) ◽

pp. 2992-3004 ◽

Cited By ~ 18

Author(s):

Veronika Ulrich ◽

Madeleine Peschke ◽

Clara Brieke ◽

Max J. Cryle

Keyword(s):

Cytochrome P450 ◽

Coupling Reaction ◽

Glycopeptide Antibiotic

Cytochrome P450 StaH catalyses the first cyclisation reaction in the biosynthesis of the glycopeptide antibiotic A47934 via recruitment to the NRPS machinery through interaction with the X-domain.

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