Enterococcal Infections

Enterococci are Gram-positive, aerobic organisms. Enterococcus faecalis and E. faecium cause a range of infections such as endocarditis, urinary tract infections, intra-abdominal infections, cellulitis and wound infections and an accompanying bacteremia.

Enterococci are part of the normal intestinal flora. They were classified as group D streptococci, but are now classified as a separate genus. There are> 17 species, but E. faecalis and E. faecium cause most infections in humans.

Enterococci are Gram-positive, aerobic organisms. Enterococcus faecalis and E. faecium cause a range of infections such as endocarditis, urinary tract infections, intra-abdominal infections, cellulitis and wound infections and an accompanying bacteremia. Enterococci are part of the normal intestinal flora. They were classified as group D streptococci, but are now classified as a separate genus. There are> 17 species, but E. faecalis and E. faecium cause most infections in humans. Enterococci typically cause UTI bacteremia endocarditis Intra-abdominal and pelvic infections wound infection therapy varies depending on the site of infection and susceptibility testing (See also the American Heart Association Infective endocarditis. Diagnosis, Antimicrobial Therapy, and Management of Complications) enterococci associated with endocarditis, are only difficult to eradicate, if not a combination of a specific cell-wall active antibiotic (eg. as penicillin, ampicillin or vancomycin) (eg. as gentamicin, streptomycin) with an aminoglycoside is used to achieve a bactericidal effect. However, some cell wall active drugs have limited or no activity against enterococci; these include nafcillin, oxacillin ticarcillin, meropenem, ertapenem, most cephalosporins and aztreonam. E. faecium are resistant to penicillin as E. faecalis. Imipenemist effective against E. faecalis. In complicated infections of the skin caused by vancomycin-sensitive enterococci daptomycin, linezolid, and Tedizolid Tigezyklin are effective treatment options. Piperacillin-tazobactam and imipenem are recommended for complicated intra-abdominal infections when enterococci known or presumed to be involved. HWI not require bactericidal treatment and when the pathogen is sensitive, usually treated with an antibiotic such as ampicillin. Nitrofurantoin and fosfomycin are often effective at HWI by vancomycin-resistant enterococcus. Resistance In the last few decades have resistance to several antimicrobial drugs developed quickly, especially at elevated E. faecium. Resistance to aminoglycosides (e.g., gentamicin, streptomycin), in particular with E. faecium, continue to emerge. Vancomycin-resistant enterococci (VRE), can also against other glycopeptides (z. B. Teicoplanin), aminoglycosides, and cell wall active ?-lactams (eg., Penicillin G, ampicillin) may be resistant. If diagnosed infected patients be strictly isolated. The recommended treatment includes streptogramins (quinupristin / dalfopristin for E. faecium) and oxazolidinones (linezolid, Tedizolid). Daptomycin and Tigezyklin have in vitro activity against VRE and may be options for off-label treatments. ?-lactamase producing enterococci occur occasionally, particularly when a large number of organisms present (z. B. in endocarditis). Clinical resistance may be present, although the organism appears sensitive due to standard tests. Vancomycin or a combination of ?-lactam / ?-lactamase inhibitor antibiotics (z. B. Piperacillin / tazobactam, ampicillin / sulbactam) can be used. For more information Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications

Health Life Media Team

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