Enterococcus: Difference between revisions
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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
- ^ 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.
