Vancomycin-Resistant Enterococcus avium Infections: Report of 2 Cases and a Review of Enterococcus avium Infections

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Enterococcus avium (EA) is a rare human pathogen and only a few case series exist. We reviewed EA infections and also report 2 cases of EA infection that were resistant to Vancomycin (VREA) and describe its clinical manifestations and mechanism of resistance. Patient 1 was diagnosed with a polymicrobial (with VREA) infected pancreatic pseudocyst. Patient 2 was diagnosed with a VREA catheter-associated cystitis. Both individuals were immunocompetent. Both VREA infected individuals were treated with and responded to linezolid. Both VREA isolates were susceptible to linezolid as defined as a MIC < 2 micrograms/mL. One strain of VREA was demonstrated to harbor a vanA gene. Thus, VREA and EA are human pathogens. Therapy with linezolid was effective. Resistance to vancomycin is mediated at least in part by vanA-mediated resistance. Infection control measures should thus be considered whenever VREA is isolated in a nosocomial setting.

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