The vanB operon encodes a D-Ala-D-Lac ligase that confers inducible vancomycin resistance. vanB-positive Enterococcus exhibit variable high-level resistance to vancomycin. Detection of vanB indicates VRE; like vanA, it mandates use of non-glycopeptide therapy and aggressive infection control. The vanB genotype often signals hospital-acquired vancomycin resistance that can spread via plasmids, underscoring the need for isolation precautions and alternative treatments (Levitus et al. 2023, Arias & Murray 2012, Hourigan et al. 2024,).
Arias CA, Murray BE. The rise of the Enterococcus: beyond vancomycin resistance. Nat Rev Microbiol. 2012 Mar 16;10(4):266-78. doi: 10.1038/nrmicro2761. PMID: 22421879; PMCID: PMC3621121.
Levitus M, Rewane A, Perera TB. Vancomycin-Resistant Enterococci. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
Hourigan, D., Stefanovic, E., Hill, C., & Ross, R. P. (2024). Promiscuous, persistent and problematic: insights into current enterococcal genomics to guide therapeutic strategy. BMC microbiology, 24(1), 103. https://doi.org/10.1186/s12866-024-03243-2
