Several reports have documented the presence of vancomycin-resistant enterococci (VRE) in the stools of asymptomatic individuals from the community who have neither recently been in hospital nor received antibiotics.
Such findings were contrary to the then existing perception of VRE as a strictly hospital-acquired infection of debilitated and immuno-compromised patients on specialized units.
Community-acquired infections with VRE are extremely rare but those that do occur may be conspicuous because of their serious nature, for example, endocarditis.
If asymptomatic faecal carriage of VRE is present in the community, individuals admitted to hospital and subjected to the selective pressures of antibiotics on the normal gut flora, may act as the source of hospital outbreaks.
VRE have also been found in sewage, from stools of healthy farm animals and animal products.
Avoparcin, a glycopeptide showing cross-resistance to medically important glycopeptides, has been used in the European Community as a growth promoter in animal feeds.
A possible link between the use of avoparcin, the selection of VRE, and humans becoming colonized via the food chain exists.
To prove such a link is beset with many difficulties : it is necessary to explain the presence of VRE in the United States where avoparcin is not used, and the predominance of the VanA gene over the VanB gene.
It is also proving difficult to show that animal and human strains are identical by means of molecular typing. (...)
Mots-clés Pascal : Enterococcus, Streptococcaceae, Micrococcales, Bactérie, Epidémiologie, Homme, Maison de ferme, Animal, Résistance traitement, Chimiothérapie, Traitement, Vancomycine, Angleterre, Grande Bretagne, Royaume Uni, Europe, Glycopeptide, Polypeptide, Bactériose, Infection, Antibactérien, Souche résistante vancomycine
Mots-clés Pascal anglais : Enterococcus, Streptococcaceae, Micrococcales, Bacteria, Epidemiology, Human, Farm house, Animal, Negative therapeutic reaction, Chemotherapy, Treatment, Vancomycin, England, Great Britain, United Kingdom, Europe, Glycopeptide, Polypeptide, Bacteriosis, Infection, Antibacterial agent
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0541518
Code Inist : 002B02S02. Création : 24/03/1998.