Enterococcus spp Overview

Enterococcus spp Overview

Enterococcal outbreaks in United States among most resistant in developed world

Background

Enterococcus faecalis and Enterococcus faecium together account for the vast majority of Enterococcus isolates. Enterococcus is an anaerobic bacterial genus that is a commensal inhabitant of the human intestine. Because of their intrinsic drug resistance, enterococci are an important pathogen in the hospital environment and are a major cause of nosocomial (health care–associated) infections. Although colonization with resistant strains is the norm, physically debilitated patients can develop endocarditis, surgical wound, urinary tract, or bloodstream infections.

The National Nosocomial Infections Surveillance (NNIS) reports Enterococcus resistance rates around 25% at the beginning of the decade, following a steep rise in the 1990s. The rise of vancomycin-resistant enterococcus (VRE) rates is disconcerting because the bug can share its resistance genes with S. aureusgiving rise to vancomycin resistance in that organism and creating a new superbug, known as VRSA. In addition, with the emergence of linezolid resistance to VRE, future treatment alternatives are becoming fewer and more expensive.