Prevalence of Resistant Enterococci in Developing Countries

Abstract

Glycopeptide resistance in enterococci is a problem of worldwide distribution, with a wider incidence in industrialized countries. This incidence is reflected as both nosocomial illnesses in the United States, because of the extensive use of antibiotic therapy, and community-borne diseases in Europe, due to the use of avoparcin as a growth promoter in animal husbandry. Vancomycin-resistant strains, however, have started to emerge in the developing world, where VRE carriers in the hospital may infect themselves upon receiving either third-generation cephalosporins to combat Gram-negative infections or vancomycin, for the treatment of severe methicillin-resistant Staphylococcus infections. Detecting VRE carriers is then of paramount importance, and although several techniques for that purpose do exist, no gold standard has been proposed to certify the accuracy or sensitivity of the assays, and it all depends on the inoculum in the intestine.