Enterococcus: Difference between revisions
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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)
References
- ^ Carl-Johan Fraenkel, Måns Ullberg, Sverker Bernander, Evalena Ericson, Peter Larsson, Johan Rydberg, Eva Törnqvist, Åsa Melhus. In vitro activities of three carbapenems against recent bacterial isolates from severely ill patients at Swedish hospitals. Scandinavian Journal of Infectious Diseases. 2006;38(10):853-859. doi:10.1080/00365540600684371.
- ^ 10.1093/jac/39.2.149
- ^ 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.
