1. Wstęp. 2. Typy oporności enterokoków na glikopeptydy. 2.1. Typ VanA. 2.2. Typ VanB (VanBl, VanB2 i VanB3). 2.3. Typ VanC (VanCl, VanC2 i VanC3). 2.4. Typ VanD. 2.5. Typ VanE. 2.6. Typ VanG. 3. Enterokoki zależne od wankomycyny. 4. Pochodzenie genow oporności na antybiotyki glikopeptydowe u Enterococcus spp. 5. Mechanizm transferu genów. 6. Rozprzestrzenianie szczepów VRE w oddziałach szpitalnych

Abstract: Antibiotic pressure resulting from the intense use of antibiotics during the last 60 years has led to the emerging problem of antibiotic resistance in bacterial strains. Enterococci (especially Enterococcus faecium) posses a number of intrinsic and acquired mechanisms of resistance. In clinical practice, resistance of Gram-positive cocci (mostly enterococci) to glycopeptide antibiotics is an important problem. During the past 15 years our knowledge about genetic background and molecular mechanisms responsible for glycopeptide resistance has been increasing. At present, there are six known types of enterococcal resistance to glycopeptides (VanA, VanB, VanC, VanD, VanE and VanG). VanA and VanB types are of major importance because of the highly efficient mechanism of horizontal gene transfer. The main reservoir of vanA and vanB genes are E. faecium and E. faecalis. VanC, VanD, VanE and VanG types are rarely found in bacteria isolated from human clinical specimens but, when present, are also a matter of concern. The common source of enterococcal van genes is also an important and interesting problem. Despite extensive search, this question still needs to be answered.

1. Introduction. 2. Types of glycopeptide resistance in enterococci. 2.1. VanA. 2.2. VanB (VanBl, VanB2 and VanB3). 2.3. VanC (VanCl, VanC2 and VanC3). 2.4. VanD. 2.5. VanE. 2.6. VanG. 3. Vancomycin-dependent enterococci. 4. Source of glycopeptide resistance genes existing in Enterococcus spp. 5. Mechanism of gene transfer. 6. Spreading of VRE strains in hospital wards