High-Level Fosfomycin Resistance in Vancomycin-Resistant Enterococcus faecium

Emerg Infect Dis. 2017 Nov;23(11):1902-1904. doi: 10.3201/eid2311.171130.

Abstract

Of 890 vancomycin-resistant Enterococcus faecium isolates obtained by rectal screening from patients in Pittsburgh, Pennsylvania, USA, 4 had MICs >1,024 μg/mL for fosfomycin. These isolates had a Cys119Asp substitution in the active site of UDP-N-acetylglucosamine enolpyruvyl transferase. This substitution increased the fosfomycin MIC >4-fold and rendered this drug inactive in biochemical assays.

Keywords: Enterococcus faecium; MurA; UDP-N-acetylglucosamine enolpyruvyl transferase; antimicrobial resistance; bacteria; fosfomycin; fosfomycin resistance; vancomycin; vancomycin resistance; vancomycin-resistant enterococci.

MeSH terms

  • Alkyl and Aryl Transferases / genetics*
  • Amino Acid Substitution
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics
  • Drug Resistance, Bacterial
  • Enterococcus faecium / drug effects
  • Enterococcus faecium / enzymology*
  • Enterococcus faecium / genetics
  • Fosfomycin / pharmacology*
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Mutation
  • Pennsylvania
  • Vancomycin / pharmacology

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Fosfomycin
  • Vancomycin
  • Alkyl and Aryl Transferases
  • UDP-N-acetylglucosamine 1-carboxyvinyltransferase