Why VRE Is a Problem

ScienceBlogling Revere links to a news article about high levels of VRE, vancomycin resistant enterococci in beach sand. While Revere and the article both describe how this indicates that VRE are established in the community, I think a far more chilling problem isn't mentioned at all: VMRSA.

What's VMRSA? Vancomycin resistant MRSA (methicillin resistant Staphylococcus aureus).

Every instance of VMRSA has involved an MRSA strain acquiring a plasmid (mini-chromosome) from a VRE strain. So far, most of these cases have occurred in Michigan. Apparently, the VRE strain that carries this particular highly transmissible plasmid is endemic to Michigan. Also, these plasmid transfer events have only occurred in very sick patients who were hospitalized, or even already in isolation--if a highly resistant strain is to evolve, this is the best place for it to happen (from the human point of view), since it's already contained.

But if VRE has established itself outside of the hospital and in the community, we're going to see a lot more VMRSA. And an epidemic strain only has to get lucky once...

More like this

Most people know that a good place to pick up an antibiotic resistant infection is in a hospital. Lots of pathogenic bugs there living (often) happily in a sea of antimicrobial agents. Better to stay away from hospitals, somewhere nice. But apparently, not at the beach:
An ahead-of-print paper in Emerging Infectious Diseases is generating some buzz in the mainstream media
It sure looks that way. Last night, I was talking to a colleague and he told me that several groups, including his, are seeing a very interesting pattern in commensal Escherichia coli (those E. coli that live in everyone's gut and aren't making us sick).
Joseph beat me to it: there's a Nature article about platensimycin, an antibiotic that inhibits lipid biosyn

We're literally on the way to re-entering the age when what used to be simple infections, from very simple injuries, can kill.

Heck, at least four cases of MRSA in the NFL this year. Makes me almost want to stop working out at the local gym.