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Uruguayan Medical Journal

ISSN: 1688-0390

Vol.21 - Nº 2 - Jun. 2005

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Vancomycin-resistant enterococcus: an emergent problem in Uruguay

Rev Med Urug 2005; 21: 151-158
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract


Enterococcus were normally considered bacterium of low pathogenicity; in the last two decades they have been increasingly determined as an important cause of hospital- acquired infection.

In the past they were categorized as Streptococcus because they are Gram-positive cocci, facultative anaerobes and catalase-negative; however, genetic studies indicated that they belonged to a new gender, Enterococcus.

They show intrinsic low antibiotic resistance to beta-lactams and aminoglucosides. They could become resistant to the same groups of antibiotics and have become resistant to glycopeptides (vancomycin and teicoplanine) which is the main problem of this gender, especially for Enterococcus faecium.

Seven resistant-glycopeptide genotypes named vanA to vanG were reported, so far only vanA y vanB have clinical impact because of their capacity of transfer among different species and gender. Vancomycin-resistant Enterococcus infection (ERV) are produced almost exclusively in hospitals. The first three cases detected in Uruguay were isolated from an urinary colony, a multibacterial intraabdominal infection and an infective endocarditis. The circulation of VRE strains in a health center demands the implementation of vigilance policies in order to identify the reservoir and set control measures against cross-transmission.

The objective of the paper is to notify Vancomycin-resistant Enterococcus faecium isolates, and a review of the issue in order to understand its significance and trascendance as well as the eventual control measures to be implemented.