Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022
Vancomycin-variable enterococci (VVE), though genetically containing <i>van</i> genes, are phenotypically sensitive to vancomycin. If VVE is undetected or does not grow on the vancomycin-resistant enterococci (VRE) selection medium, or both, it can acquire resistance upon exposure to van...
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MDPI AG
2024-12-01
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| author | Sung Young Lee Ji-Hyun Nam Jung Wook Kim Soo Hyun Kim Jung Sik Yoo |
| author_facet | Sung Young Lee Ji-Hyun Nam Jung Wook Kim Soo Hyun Kim Jung Sik Yoo |
| author_sort | Sung Young Lee |
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| description | Vancomycin-variable enterococci (VVE), though genetically containing <i>van</i> genes, are phenotypically sensitive to vancomycin. If VVE is undetected or does not grow on the vancomycin-resistant enterococci (VRE) selection medium, or both, it can acquire resistance upon exposure to vancomycin. This characteristic is clinically important for the treatment and prevention of VRE. This study aims to analyze the prevalence and characteristics of VVE in Korea through the Global Antibiotic Resistance Surveillance System (Kor-GLASS) and emphasize the importance of VVE. A total of 3342 enterococcal bloodstream isolates were collected through the Kor-GLASS between 2017 and 2022. Antibiotic susceptibility testing, <i>van</i> gene detection, and multilocus sequence typing were conducted with all the isolates. The trends in the domestic prevalence of VVE were analyzed and compared with global prevalence data. Among the isolates, 197 (5.9%), including 124 <i>Enterococcus faecium</i> and 73 <i>E. faecalis</i>, were identified as VVE. While the VRE incidence has declined in Korea since 2020, the VVE incidence is significantly rising. In Korea, only the <i>vanA</i> gene has been detected in both VRE and VVE, and no other <i>van</i> gene variants have been identified. Most of these isolates belong to CC17 (91.3%), with ST17, ST817, and ST80 as the predominant types. We have shown that continuous surveillance is essential in Korea due to the persistently high prevalence of VRE and the potential evolution of VVE into VRE. Consequently, it is critical to evaluate <i>Enterococcus</i> species isolated from domestic clinical settings for their phenotypic vancomycin resistance and the molecular detection of <i>van</i> genes, irrespective of the strain. |
| format | Article |
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| issn | 2079-6382 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Antibiotics |
| spelling | doaj-art-dbb2a12d6d9e401d83e6fb28f3f373d32025-08-20T02:00:59ZengMDPI AGAntibiotics2079-63822024-12-011312121010.3390/antibiotics13121210Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022Sung Young Lee0Ji-Hyun Nam1Jung Wook Kim2Soo Hyun Kim3Jung Sik Yoo4Division of Antimicrobial Resistance Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of KoreaDivision of Antimicrobial Resistance Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of KoreaDivision of Zoonotic and Vector-Borne Disease Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of KoreaDepartment of Laboratory Medicine, Chonnam National University Medical School, Gwangju-si 61469, Republic of KoreaDivision of Antimicrobial Resistance Research, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of KoreaVancomycin-variable enterococci (VVE), though genetically containing <i>van</i> genes, are phenotypically sensitive to vancomycin. If VVE is undetected or does not grow on the vancomycin-resistant enterococci (VRE) selection medium, or both, it can acquire resistance upon exposure to vancomycin. This characteristic is clinically important for the treatment and prevention of VRE. This study aims to analyze the prevalence and characteristics of VVE in Korea through the Global Antibiotic Resistance Surveillance System (Kor-GLASS) and emphasize the importance of VVE. A total of 3342 enterococcal bloodstream isolates were collected through the Kor-GLASS between 2017 and 2022. Antibiotic susceptibility testing, <i>van</i> gene detection, and multilocus sequence typing were conducted with all the isolates. The trends in the domestic prevalence of VVE were analyzed and compared with global prevalence data. Among the isolates, 197 (5.9%), including 124 <i>Enterococcus faecium</i> and 73 <i>E. faecalis</i>, were identified as VVE. While the VRE incidence has declined in Korea since 2020, the VVE incidence is significantly rising. In Korea, only the <i>vanA</i> gene has been detected in both VRE and VVE, and no other <i>van</i> gene variants have been identified. Most of these isolates belong to CC17 (91.3%), with ST17, ST817, and ST80 as the predominant types. We have shown that continuous surveillance is essential in Korea due to the persistently high prevalence of VRE and the potential evolution of VVE into VRE. Consequently, it is critical to evaluate <i>Enterococcus</i> species isolated from domestic clinical settings for their phenotypic vancomycin resistance and the molecular detection of <i>van</i> genes, irrespective of the strain.https://www.mdpi.com/2079-6382/13/12/1210global antibiotic resistance surveillance system in Korea<i>vanA</i> genevancomycin susceptiblevancomycin-resistant enterococcivancomycin-variable enterococci |
| spellingShingle | Sung Young Lee Ji-Hyun Nam Jung Wook Kim Soo Hyun Kim Jung Sik Yoo Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 Antibiotics global antibiotic resistance surveillance system in Korea <i>vanA</i> gene vancomycin susceptible vancomycin-resistant enterococci vancomycin-variable enterococci |
| title | Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 |
| title_full | Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 |
| title_fullStr | Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 |
| title_full_unstemmed | Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 |
| title_short | Prevalence of Vancomycin-Variable Enterococci from the Bloodstream in the Korea Global Antibiotic Resistance Surveillance System, 2017–2022 |
| title_sort | prevalence of vancomycin variable enterococci from the bloodstream in the korea global antibiotic resistance surveillance system 2017 2022 |
| topic | global antibiotic resistance surveillance system in Korea <i>vanA</i> gene vancomycin susceptible vancomycin-resistant enterococci vancomycin-variable enterococci |
| url | https://www.mdpi.com/2079-6382/13/12/1210 |
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