VanA and VanB are the main genes responsible for vancomycin resistance in enterococci. They alter the bacterial cell wall target so vancomycin cannot bind effectively. VanA confers high-level resistance to both vancomycin and teicoplanin, while VanB typically confers resistance to vancomycin but not teicoplanin.
Detection of VanA or VanB in molecular susceptibility testing identifies vancomycin-resistant enterococcus (VRE) infections, which typically require linezolid, daptomycin, or other alternative agents. It also triggers infection control precautions to prevent transmission. Sample type is typically a culture isolate or rectal swab.
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