Enterococcus: Difference between revisions

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Enterococcus
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m (Text replacement - "Catalase test::catalase-negative" to "catalase Catalase::negative")
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===Microbiology===
 
===Microbiology===
   
*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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*Facultative anaerobic, non-spore-forming, [[Hemolysis pattern::α-hemolytic|alpha-]] or [[Hemolysis pattern::γ-hemolytic|gamma-hemolytic]], catalase [[Catalase::negative]], [[Stain::Gram-positive]] [[Cellular shape::cocci]]
 
*Grows on bile esculin agar
 
*Grows on bile esculin agar
 
*[[PYR test|PYR]] positive
 
*[[PYR test|PYR]] positive

Revision as of 15:08, 20 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
  • PYR positive
  • 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

References

  1. ^  James H. Jorgensen, Sharon A. Crawford, Cynthia C. Kelly, Jan E. Patterson. In VitroActivity of Daptomycin against Vancomycin-Resistant Enterococci ofVarious Van Types and Comparison of Susceptibility TestingMethods. Antimicrobial Agents and Chemotherapy. 2003;47(12):3760-3763. doi:10.1128/aac.47.12.3760-3763.2003.