Enterococcus: Difference between revisions
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Enterococcus
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=== Microbiology === |
=== Microbiology === |
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* Facultative anaerobic, non-spore-forming, alpha- or gamma-hemolytic, [[Stain::Gram-positive]] [[Cellular shape::cocci]] |
* Facultative anaerobic, non-spore-forming, [[Hemolysis pattern::α-hemolytic|alpha-]] or [[Hemolysis pattern::γ-hemolytic|gamma-hemolytic]], [[Catalase test::catalase-negative]], [[Stain::Gram-positive]] [[Cellular shape::cocci]] |
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* Grows on bile esculin agar |
* Grows on bile esculin agar |
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* Most are Lancefield group D |
* Most are Lancefield group D |
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Revision as of 01:00, 5 August 2020
Background
Microbiology
- Facultative anaerobic, non-spore-forming, alpha- or gamma-hemolytic, catalase-negative, Gram-positive cocci"cocci" is not in the list (coccus, bacillus, coccobacillus, diplococcus, spirochete, curved, pleomorphic, yeast, mold) of allowed values for the "Shape" property.
- Grows on bile esculin agar
- Most are Lancefield group D
- 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
Vacomycin 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)
