Plasmid-Mediated Resistance to Vancomycin and Teicoplanin in Enterococcus Faecium

THE glycopeptide antibiotic agents vancomycin and teicoplanin are useful in the treatment of severe infections due to gram-positive bacteria.^{1 2 3} Staphylococci, streptococci, and enterococci are almost always susceptible to these agents, which constitute an alternative to the penicillins in cases of resistance or intolerance.Resistance to glycopeptides is extremely common in leuconostoc species⁴ and pediococcus species and also occurs in lactobacilli.^{5 , 6} These gram-positive bacteria rarely cause infections and are considered opportunistic pathogens. The emergence of strains of Staphylococcus haemolyticus that became resistant during vancomycin therapy has recently been reported.⁷ Resistance to vancomycin is rare in streptococci.⁸ Enterococcal isolates with minimal inhibitory . . .