An Overview on Vancomycin Resistant Enterococcus faecalis

Abstract

There are over 15 species of the Enterococcus genus, 80-90% of clinical isolates as E. faecalis. The aim of this work is to review the current information on Vancomycin resistant Enterococcus fecalis. The study reviewed using electronic documents and hard copies from public libraries of relevant literatures relating to biology, epidemiology, drug resistance mechanism, treatment, and control of Enterococcus faecalis. The review revealed that Enterocuccus faecalis formerly known as Streptococcus faecalis is a Gram-positive commensal bacterium that inhabits the gastrointestinal tracts of healthy humans and other mammals. However, it can cause life- threatening infections in humans, especially in the nosocomial environment, where there are naturally high levels of antibiotic resistance. Thus, Enterococci have proven to present a therapeutic challenge because of their resistance to many antimicrobial drugs, including cell-wall active agents; aminoglycosides, penicillin, ampicillin, and vancomycin.” The Enterococci have the capacity to acquire a wide variety of antimicrobial resistance factors through plasmid transfer by conjugation, which present serious problems in the management of patients with Enterococcal infections. In general, Enterococcal isolates with lowered susceptibility to vancomycin are categorized as vanA, vanB, and vanC, vanA and vanB pose the greatest threat because they are the most resistant genes.E. faecalis are also resistant to teicoplanin. Enterococcal strains that are vancomycin-dependent have been found, but are rare and less common than vancomycin-resistant strains (referred to as “vancomycin-resistant Enterococci” or “VRE”). The review, identified that although VRE infection possess the tendency to become endemic especially in very ill debilitated patients who have been exposed to broad spectrum antibiotics; and the immune-compromised, yet Vancomycin continues to be the drug of choice for serious life threatening infections as  sepsis, pneumonia, and endocarditis.