Enterococci Grp D

- 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

Low Rate of Infection Control in Enterococcal Periprosthetic Joint Infections 

Medical Intelligence: Plasmid-Mediated Resistance To Vancomycin And Teicoplanin In Enterococcus Faecium.

Enterococcus species in urinary tract infection.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, November 29, 2012 11:12 am