Enterococcus: Difference between revisions
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Enterococcus
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===Microbiology=== |
===Microbiology=== |
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*Genus of 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::coccus|cocci]] |
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*Grows on bile esculin agar |
*Grows on bile esculin agar |
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*[[PYR test|PYR]] positive |
*[[PYR test|PYR]] positive |
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Revision as of 15:10, 22 August 2020
Background
Microbiology
- Genus of facultative anaerobic, non-spore-forming, alpha- or gamma-hemolytic, catalase negative, Gram-positive cocci
- 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
- Daptomycin, doxycycline, linezolid, tedizolid, oritavancin, quinupristin-dalfopristin (for E. faecium)
