Enterococcus: Difference between revisions
From IDWiki
Enterococcus
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** More common (90-95%) |
** More common (90-95%) |
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** More commonly genitourinary source |
** More commonly genitourinary source |
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** More |
** More susceptible to antibiotics |
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* ''E. faecium'' |
* ''E. faecium'' |
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** Less common (5-10%) |
** Less common (5-10%) |
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** More commonly gastrointestinal source |
** More commonly gastrointestinal source |
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** Less |
** Less susceptible to antibiotics |
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** Most common VRE |
** Most common VRE |
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* ''E. gallinarum'' |
* ''E. gallinarum'' |
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Revision as of 21:21, 19 January 2020
Background
Microbiology
- Facultative anaerobic, non-spore-forming, gamma-hemolytic, Gram positive diplococci
- Commensal gut flora
- Increasing antibiotic resistance
Species
- E. faecalis
- More common (90-95%)
- More commonly genitourinary source
- More susceptible to antibiotics
- E. faecium
- Less common (5-10%)
- More commonly gastrointestinal source
- Less susceptible to antibiotics
- Most common VRE
- E. gallinarum
- E. casseliflavus
Resistance
- Vancomycin binds to d-Ala-d-Ala pentapeptids, interfering with cell wall synthesis
- VanA: most common. Mutation to d-Ala-d-Lac, leading to high resistance to glycopeptides.
- VanB: more common in E. faecium in Australia
- VanC: chromosomal resistance on E. gallinarum and E. casseliflavus
Management
VRE
- Daptomycin, doxycycline, linezolid, tedizolid, oritavancin, quinupristin-dalfopristin (for E. faecium)
