Enterococcus: Difference between revisions
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Important clinical infections caused by ''Enterococcus'' include [[urinary tract infection]]s, [[bacteremia]], [[bacterial endocarditis]], [[diverticulitis]], and [[meningitis]].<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = 294–5 |publisher = McGraw Hill | year = 2004 | isbn = 0-8385-8529-9 }}</ref> Sensitive strains of these bacteria can be treated with [[ampicillin]] and [[vancomycin]].<ref name=Baron>{{cite book | author = Pelletier LL Jr. | title = Microbiology of the Circulatory System. ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.5077 | isbn = 0-9631172-1-1 }}</ref> |
Important clinical infections caused by ''Enterococcus'' include [[urinary tract infection]]s, [[bacteremia]], [[bacterial endocarditis]], [[diverticulitis]], and [[meningitis]].<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = 294–5 |publisher = McGraw Hill | year = 2004 | isbn = 0-8385-8529-9 }}</ref> Sensitive strains of these bacteria can be treated with [[ampicillin]] and [[vancomycin]].<ref name=Baron>{{cite book | author = Pelletier LL Jr. | title = Microbiology of the Circulatory System. ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.5077 | isbn = 0-9631172-1-1 }}</ref> |
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From a medical standpoint, the most important feature of this genus is their high level of endemic [[antibiotic resistance]]. Some Enterococci are [[Wiktionary:intrinsic|intrinsically]] resistant to β-lactam-based antibiotics (some [[penicillin]]s and virtually all [[cephalosporin]]s) as well as many [[aminoglycoside]]s.<ref name=Sherris /> In the last two decades, particularly virulent strains of ''Enterococcus'' which are resistant to vancomycin ([[Vancomycin- |
From a medical standpoint, the most important feature of this genus is their high level of endemic [[antibiotic resistance]]. Some Enterococci are [[Wiktionary:intrinsic|intrinsically]] resistant to β-lactam-based antibiotics (some [[penicillin]]s and virtually all [[cephalosporin]]s) as well as many [[aminoglycoside]]s.<ref name=Sherris /> In the last two decades, particularly virulent strains of ''Enterococcus'' which are resistant to vancomycin ([[Vancomycin-resistant enterococcus]], or VRE) have emerged in [[nosocomial]] infections of hospitalized patients especially in the US. Other developed countries such as the UK have been spared this epidemic, and in 2005, Singapore managed to halt an epidemic of VRE. VRE may be treated with Quinupristin/dalfopristin (Synercid) with response rates of approximately 70%.<ref name=Tünger_2004>{{cite journal |author=Tünger A, Aydemir S, Uluer S, Cilli F |title=In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci |journal=Indian J Med Res |volume=120 |issue=6 |pages=546-52 |year=2004 |id=PMID 15654141}}</ref> |
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Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous [[vancomycin]]; [[intrathecal]] vancomycin is often used and it is debatable whether this has any impact on outcome. The removal of any neurological devices is a crucial part of the management of these infections.<ref name=Guardado_2006>{{cite journal |author=Guardado R, Asensi V, Torres JM, ''et al'' |title=Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases |journal=Scand. J. Infect. Dis. |volume=38 |issue=8 |pages=584-8 |year=2006 |pmid=16857599 |doi=10.1080/00365540600606416}}</ref> |
Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous [[vancomycin]]; [[intrathecal]] vancomycin is often used and it is debatable whether this has any impact on outcome. The removal of any neurological devices is a crucial part of the management of these infections.<ref name=Guardado_2006>{{cite journal |author=Guardado R, Asensi V, Torres JM, ''et al'' |title=Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases |journal=Scand. J. Infect. Dis. |volume=38 |issue=8 |pages=584-8 |year=2006 |pmid=16857599 |doi=10.1080/00365540600606416}}</ref> |
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Revision as of 21:16, 1 March 2008
| Enterococcus | |
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| Enterococcus sp. infection in pulmonary tissue. | |
| Scientific classification | |
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| Genus: | Enterococcus (ex Thiercelin & Jouhaud 1903)
Schleifer & Kilpper-Bälz 1984 |
| Species | |
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E. avium | |
Enterococcus is a genus of lactic acid bacteria of the phylum Firmicutes. Members of this genus were classified as Group D Streptococcus until 1984 when genomic DNA analysis indicated that a separate genus classification was appropriate.[1]
Enterococci are Gram-positive cocci which often occur in pairs (diplococci) and are difficult to distinguish from Streptococci on physical characteristics alone. Two species are common commensal organisms in the intestines of humans: E. faecalis (90-95%) and E. faecium (5-10%). Enterococci are facultative anaerobic organisms, i.e. they prefer the use of oxygen, but they can survive in the absence of oxygen.[2] They typically exhibit gamma-hemolysis on sheep's blood agar.
Pathology
Important clinical infections caused by Enterococcus include urinary tract infections, bacteremia, bacterial endocarditis, diverticulitis, and meningitis.[3] Sensitive strains of these bacteria can be treated with ampicillin and vancomycin.[4]
From a medical standpoint, the most important feature of this genus is their high level of endemic antibiotic resistance. Some Enterococci are intrinsically resistant to β-lactam-based antibiotics (some penicillins and virtually all cephalosporins) as well as many aminoglycosides.[3] In the last two decades, particularly virulent strains of Enterococcus which are resistant to vancomycin (Vancomycin-resistant enterococcus, or VRE) have emerged in nosocomial infections of hospitalized patients especially in the US. Other developed countries such as the UK have been spared this epidemic, and in 2005, Singapore managed to halt an epidemic of VRE. VRE may be treated with Quinupristin/dalfopristin (Synercid) with response rates of approximately 70%.[5]
Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous vancomycin; intrathecal vancomycin is often used and it is debatable whether this has any impact on outcome. The removal of any neurological devices is a crucial part of the management of these infections.[6]
Water quality
In bodies of water, the acceptable level of contamination is very low, for example in the state of Hawaii, with among the strictest tolerances in the United States, the limit for water off its beaches is 7 colony forming units per 100 ml of water, above which the state may post warnings to stay out of the ocean.[7] In 2004, Enterococcus spp. took the place of fecal coliform as the new federal standard for water quality at public beaches. It is believed to provide a higher correlation than fecal coliform with many of the human pathogens often found in sewage.[8]
References
- ^ Schleifer KH; Kilpper-Balz R (1984). "Transfer of Streptococcus faecalis and Streptococcus faecium to the genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov". Int. J. Sys. Bacteriol. 34: 31–34.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Fischetti VA; Novick RP; Ferretti JJ; Portnoy DA; Rood JI (editors) (2000). Gram-Positive Pathogens. ASM Press. ISBN 1-55581-166-3.
{{cite book}}:|author=has generic name (help)CS1 maint: multiple names: authors list (link) - ^ a b Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 294–5. ISBN 0-8385-8529-9.
{{cite book}}:|author=has generic name (help);|edition=has extra text (help) - ^ Pelletier LL Jr. (1996). Microbiology of the Circulatory System. in: Baron's Medical Microbiology (Baron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
{{cite book}}:|edition=has extra text (help) - ^ Tünger A, Aydemir S, Uluer S, Cilli F (2004). "In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci". Indian J Med Res. 120 (6): 546–52. PMID 15654141.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Guardado R, Asensi V, Torres JM; et al. (2006). "Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases". Scand. J. Infect. Dis. 38 (8): 584–8. doi:10.1080/00365540600606416. PMID 16857599.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: multiple names: authors list (link) - ^ "Clean Water Branch". Hawaii State Department of Health. Retrieved 2007-02-08.
- ^ Jin G, Jeng HW, Bradford H, Englande AJ (2004). "Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment". Water Environ. Res. 76 (3): 245–55. PMID 15338696.
{{cite journal}}: CS1 maint: multiple names: authors list (link)