Enterococci are ubiquitous, facultative, anaerobic Gram-positive bacteria that mainly reside, as part of the normal microbiota, in the gastrointestinal tracts of several animal species, including humans. These bacteria have the capability to turn from a normal gut commensal organism to an invasive pathogen in patients debilitated by prolonged hospitalization, concurrent illnesses, and/or exposed to broad-spectrum antibiotics. The majority of vancomycin-resistant enterococcus (VRE) infections are linked to the vanA genotype; however, outbreaks caused by vanB-type VREs have been increasingly reported, representing a new challenge for effective antimicrobial treatment. Teicoplanin, daptomycin, fosfomycin, and linezolid are useful antimicrobials for infections due to vanB enterococci. In addition, new drugs have been developed (e.g., dalbavancin, telavancin, and tedizolid), new molecules will soon be available (e.g., eravacycline, omadacycline, and oritavancin), and new treatment strategies are progressively being used in clinical practice (e.g., combination therapies and bacteriophages). The aim of this article is to discuss the pathogenesis of infections due to enterococci harboring the vanB operon (vanBVRE) and their therapeutic, state-of-the-art, and future treatment options and provide a comprehensive and easy to use review for clinical purposes.

中文翻译：

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vanB 基因型耐万古霉素肠球菌感染的治疗选择

肠球菌是普遍存在的兼性厌氧革兰氏阳性菌，作为正常微生物群的一部分，主要存在于包括人类在内的几种动物的胃肠道中。在因长期住院、并发疾病和/或暴露于广谱抗生素而虚弱的患者中，这些细菌能够从正常的肠道共生生物转变为侵入性病原体。大多数耐万古霉素肠球菌 (VRE) 感染与 vanA 基因型有关；然而，由 vanB 型 VRE 引起的暴发的报道越来越多，这对有效的抗菌治疗提出了新的挑战。替考拉宁、达托霉素、磷霉素和利奈唑胺是治疗 vanB 肠球菌感染的有用抗菌药物。此外，还开发了新药（例如，达巴万星、特拉万星和泰地唑胺），新的分子将很快面世（例如，依拉万星、奥马环素和奥利万星），并且新的治疗策略正逐步用于临床实践（例如，联合疗法和噬菌体）。本文的目的是讨论由带有 vanB 操纵子 (vanBVRE) 的肠球菌引起的感染的发病机制及其治疗、最新技术和未来的治疗选择，并为临床目的提供全面且易于使用的综述.