- Discussion:
- type of
gram positive bacteria;
- term enterococcus derives from French (enterocoque) describing its enertic origin;
- enterococci include: Strep faecalis, faicium, and durans;
- strep faecalis inhabits the human intestinal tract and is a nonhemolytic strain of generally low pathogenicity;
- enterococcus is a common participant in diabetic infections & can give rise to bacteremia (and
endocarditis);
- these organisms are most often a secondary invader of urinary tract and they are present only in complicated
UTI;
- this organism is extremely hardy and can often grow adequately under conditions lethal to most other micro-organisms;
- Treatment:
- enterococci are always resistant to cephalosporins &
clindamycin but are sensitive to semisynthetic penicillins,
ampicillin,
imipenem, &
cipro;
- enterococal group D streptococci, unlike
streptococcal, are resistant to penicillins and
aminoglycosides, but synergy in killing
is achieved with the combination of both drugs;
- this combination is indicated in
endocarditis, some cases of osteomyelitis, and possibly in diabetic foot infections;
-
vancomycin is the agent of choice for organisms resistant to
ampicillin;
-
vancomycin resistant enterococcus:
- note that these organisms can survive on non-organic objects for prolonged periods of time (eg blood pressure cuffs and/or
stethoscopes), and therefore a "true" isolation environment is required for these patients (gowns, masks, hand washing,
gloves, as well as a dedicated blood pressure cuff, stethoscope ect);
- handwashing with an antiseptic after glove removal;
- dedication of equipment such as stethoscopes to the patients room;
- avoiding contact with environmental surfaces such as doorknobs;
- synercid (quinupristin/dalfopristin) IV is approved for systemic infections due to VRE
Medical Intelligence: Plasmid-Mediated Resistance To Vancomycin And Teicoplanin In Enterococcus Faecium.
Enterococcus species in urinary tract infection.
