Vancomycin resistance: Status quo and quo vadis

The prevalence of vancomycin resistance is steadily rising among clinical i solates of Enterococcus spp., thereby limiting the treatment options for in fections caused by vancomycin-resistant enterococci. The precise nature of the glycopeptide resistance genes has been elucidated, and many studies on gene reservoirs and strain-versus-resistance-gene epidemiology have been pe rformed. The prevalence of vancomycin-resistant enterococci in various clin ical and environmental settings in relation to nosocomial and veterinary ap plications of antimicrobial glycopeptides is discussed in detail in this re view. Novel molecular tools for the identification of vancomycin-resistant enterococci genomes or the various resistance genes have been applied in or der to expand current insight into the overall epidemiology of the resistan ce trait itself. The risk of the spread of vancomycin resistance to other b acterial species was recently underscored by the emergence of staphylococci showing clinical resistance to vancomycin. The topics mentioned above are elaborated on and discussed in light of the increasing medical concern on t he future detection of microbial infections beyond chemotherapeutic cure.