Enterococcus: Difference between revisions
From IDWiki
Enterococcus
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* '''VanB''': more common in ''E. faecium'' in Australia |
* '''VanB''': more common in ''E. faecium'' in Australia |
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* '''VanC''': chromosomal resistance on ''E. gallinarum'' and ''E. casseliflavus'' |
* '''VanC''': chromosomal resistance on ''E. gallinarum'' and ''E. casseliflavus'' |
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== Management == |
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=== VRE === |
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* [[Is treated by::Daptomycin]], [[Is treated by::doxycycline]], [[Is treated by::linezolid]], [[Is treated by::tedizolid]], [[Is treated by::oritavancin]], [[Is treated by::quinupristin-dalfopristin]] (for ''E. faecium'') |
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{{DISPLAYTITLE:''Enterococcus'' species}} |
{{DISPLAYTITLE:''Enterococcus'' species}} |
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Revision as of 21:20, 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 sensitive to antibiotics
- E. faecium
- Less common (5-10%)
- More commonly gastrointestinal source
- Less sensitive 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.
- ^ 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.
