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1. Introduction
2. GRE: where it all began
3. Prevalence of GRE in the UK
4. GRE bacteraemias, EARSS 2008
5. Vancomycin resistant enterococci in the US
6. GRE are a localised problem in the UK
7. Enterococci as opportunist pathogens
8. Risk factors for GRE infection
9. The clinical problem with GRE - mutliresistance
10. Enterococcus species
11. Glycopeptide resistance in enterococci
12. Characteristics of glycopeptide resistance
13. GRE: primarily E. faecium with VanA
14. Glycopeptide action and resistance
15. GRE...all because of one critical H-bond
16. Regulation of glycopeptide resistance (VanA)
17. Cell wall synthesis in GRE
18. Glycopeptide dependent enterococci
19. Cell wall synthesis in resistant enterococci
20. Resistant isolates
21. PFGE analysis: the "gold standard" method
22. A national epidemic of GRE in the UK?
23. Avoparcin and VanA resistance
24. MLST of 720 E. faecium isolates
25. Hospital-adapted lineages
26. Virulence of E. faecalis
27. Resistance genes and elements
28. Genetic exchange in enterococci
29. The van gene clusters of enterococci
30. Transposons carry van gene clusters
31. A national epidemic of VanA elements?
32. VanA elements in the UK
33. Origins of resistant enterococci affecting humans
34. Diversity among VanA elements
35. Transfer of van genes beyond enterococci
36. VanA MRSA has arrived
37. Glycopeptide MICs for two VRSA strains
38. Poor detection of some VRSA
39. Glycopeptide-intermediate S. aureus (GISA)
40. Biochemical basis of resistance in GISA
41. Resistance to new agents: the red queen theory
42. Quinupristin-dalfopristin vs. enterococci
43. 'Q-D' resistance mechanisms in enterococci
44. Linezolid resistance in enterococci
45. Development of linezolid resistance
46. Linezolid resistance - summary
47. Daptomycin: a cyclic lipopeptide
48. Daptomycin: mechanism of action
49. Daptomycin: resistance issues, E. faecium
50. Second generation glycopeptides (1)
51. Vancomycin's and teicoplanin's modes of action
52. Second generation glycopeptides (2)
53. In vitro activity vs. enterococci
54. Telavancin vs. GRE
55. Potential for a better anti GRE glycopeptide
56. Epidemiology of GRE
57. Acknowledgements

Topics Covered

• Original description
• Rates of resistance
• Types of infections
• Risk factors
• Resistance profiles of major species
• Types of vancomycin resistance
• Resistance mechanism
• Cell wall structure
• Glycopeptide dependence
• Epidemiological investigation
• Virulence factors
• Van gene clusters
• VanA S. aureus
• VISA
• 'New' anti-GRE agents and resistance
• New glycopeptides

Links

Series:

• Antibiotic Resistance

Categories:

• Clinical Practice
• Microbiology
• Pharmaceutical Sciences

Therapeutic Areas:

• Infectious Diseases

Talk Citation

Publication History

• Published on December 31, 2009

Financial Disclosures

• Dr. Neil Woodford has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.