Infectious Disease Book

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Vancomycin Resistant EnterococcusAka: VRE

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  1. Epidemiology
    1. Multi-drug resistance (some sensitive to Tetracycline)
    2. Marked recent increase (14% resistance in ICU's)
  2. Pathophysiology
    1. Enterococcus is fecal flora in 56-100% adults
    2. Organisms showing resistance
      1. Enterococcus faecium
      2. Enterococcus faecalis
  3. Risk factors associated with infection
    1. Compromised hosts
    2. Associated Conditions
      1. Endocarditis
      2. Urinary Tract Infections
      3. Meningitis
      4. Wound infections
      5. Intravenous catheter infections
  4. Management of Vancomycin Resistant Enterococcus
    1. No single antibiotic is bactericidal
      1. Combination therapy is mandatory
    2. Susceptible to Ampicillin
      1. Antibiotic 1
        1. Ampicillin or
        2. Ampicillin/Sulbactam (Unasyn)
      2. Antibiotic 2
        1. Gentamicin
        2. Streptomycin
    3. High resistance to Ampicillin (MIC >64 mg/ml)
      1. Quinupristin/dalfopristin (Synercid)
      2. Linezolid (Zyvox)
      3. Combination 1 (three drugs)
        1. Ciprofloxacin and
        2. Rifampin and
        3. Gentamicin
      4. Combination 2 (two drugs)
        1. Cefotaxime or Ceftriaxone and
        2. Fosfomycin
      5. Combination 3 (four drugs)
        1. Chloramphenicol and
        2. Doxycycline and
        3. Rifampin and
        4. Quinupristin/dalfopristin (Synercid)
  5. References
    1. Michel (1997) Lancet 349:1901
    2. Murray (2000) N Engl J Med 342:710

Vancomycin resistant enterococcus (C1265175)

ConceptsBacterium (T007)
EnglishVancomycin resistant enterococcus, VRE
SpanishEnterococcus resistente a la vancomicina, enterococo resistente a la vancomicina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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