Phenotypes of vancomycin-resistant enterococci (VRE)

Phenotype	Ligase gene	Ending of peptidoglycan*	MIC vancomycin (mcg/mL)	MIC teicoplanin (mcg/mL)	Transferability between strains	Species
VanA	vanA	D-Ala-D-Lac	64 to 1000	16 to 512	YES	E. faecium, E. faecalis, E. durans, E. hirae, E. gallinarum, E. casseliflavus, E. raffinosus, E. avium, E. mundtii
VanB	vanB	D-Ala-D-Lac	4 to 32	0.5 to 1	YES	E. faecium, E. faecalis, E. durans, E. gallinarum
VanC	vanC	D-Ala-D-Ser	8 to 32	0.5 to 1	NO	E. gallinarum, E. casseliflavus
VanD	vanD	D-Ala-D-Lac	64 to 128	4 to 64	NO	E. faecium, E. faecalis, E. raffinosus
VanE	vanE	D-Ala-D-Ser	8 to 32	0.5 to 1	NO	E. faecalis
VanG	vanG	D-Ala-D-Ser	8 to 16	0.5 to 1	YES	E. faecalis
VanL	vanL	D-Ala-D-Ser^¶	8	0.5	NO	E. faecalis
VanM	vanM	D-Ala-D-Lac^¶	>256	64 to >256	YES	E. faecium
VanN	vanN	D-Ala-D-Ser^¶	8	0.5	YES	E. faecium

D-Ala-D-Lac: D-alanine-D-lactate; D-Ala-D-Ser: D-alanine-D-serine; MIC: minimal inhibitory concentration.
* Refers to the last two amino acids of peptidoglycan precursors, which are normally D-Ala-D-Ala; in some phenotypes, the ending is deduced from the amino acid sequence of the corresponding ligase.
¶ Predicted but not actually confirmed.

Courtesy of Cesar Arias, MD, and Barbara Murray, MD.

Graphic 83403 Version 5.0

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Phenotypes of vancomycin-resistant enterococci (VRE)