Integration of vanHAX downstream of a ribosomal RNA operon restores vancomycin resistance in a susceptible Enterococcus faecium strain
2024

Restoring Vancomycin Resistance in Enterococcus faecium

Sample size: 39 publication 10 minutes Evidence: moderate

Author Information

Author(s): McInnes Ross S., Snaith Ann E., Dunn Steven J., Papangeli Maria, Hardy Katherine J., Hussain Abid, van Schaik Willem

Primary Institution: University of Birmingham

Hypothesis

Can the integration of vanHAX genes restore vancomycin resistance in a susceptible Enterococcus faecium strain?

Conclusion

The study found that the integration of vanHAX genes downstream of a ribosomal RNA operon can restore vancomycin resistance in Enterococcus faecium.

Supporting Evidence

  • Isolate OI25 was found to carry vanHAX genes but was phenotypically susceptible to vancomycin.
  • Upon exposure to vancomycin, OI25 could revert to a resistant phenotype.
  • Constitutive expression of vanHAX genes was observed in revertant isolates.
  • Revertant isolates did not exhibit significant growth defects despite high-level expression of resistance genes.

Takeaway

Some bacteria can seem weak but can become strong again when they are around certain medicines. This study shows how a specific bacteria can turn back into a strong one that can fight off a medicine called vancomycin.

Methodology

The study involved genomic characterization, long-read sequencing, and RT-qPCR analysis to investigate the mechanisms of vancomycin resistance.

Limitations

The study was limited to isolates from a specific hospital ward and may not represent all Enterococcus faecium strains.

Participant Demographics

Isolates were collected from 24 patients in a haematology ward.

Digital Object Identifier (DOI)

10.1038/s44259-023-00017-0

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