Enterococcus faecalis
| Enterococcus faecalis | ||||||||||||||
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| Enterococcus faecalis as viewed through a scanning electron microscope Enterococcus faecalis as viewed through a scanning electron microscope
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| Scientific classification | ||||||||||||||
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| Binomial name | ||||||||||||||
| Enterococcus faecalis (Orla-Jensen 1919) Schleifer & Kilpper-Bälz 1984 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Enterococcus faecalis is a Gram-positive commensal bacterium inhabiting the gastrointestinal tracts of humans and other mammals.[1] Like other species in the genus Enterococcus, E. faecalis can cause life-threatening infections in humans, especially in the nosocomial (hospital) environment: the naturally high levels of antibiotic resistance found in E. faecalis contribute to its pathogenicity.[1]
Pathogenesis
E. faecalis can cause endocarditis, as well as bladder, prostate, and epididymal infections; nervous system infections are less common.[1][2]
E. faecalis is resistant to many commonly used antimicrobial agents (aminoglycosides, aztreonam, cephalosporins, clindamycin, the semi-synthetic penicillins nafcillin and oxacillin, and trimethoprim-sulfamethoxazole). Exposure to cephalosporins is a particularly important risk factor for colonization and infection with enterococci.
Historical
Prior to 1984, enterococci were members of the genus Streptococcus: thus E. faecalis was known as Streptococcus faecalis.[3]
Treatment
Antimicrobial Regimen
- Enterococcus faecalis
- Bacteremia, catheter-related infection
- Preferred regimen: Ampicillin 9-12 g daily IV in divided doses q4-6h for 14 days OR Penicillin G 8-30 million units IV daily divided q4-6h for 14 days OR Vancomycin 30 mg/kg daily IV in divided doses for 14 days
- Endocarditis
- Preferred regimen:
- Vancomycin resistent :
- High level resistance to aminoglycoisdes
- Ampicillin AND (aminoglycosides OR ceftriaxone)
- If penicillin allergy and cannot desensitize: Daptomycin AND aminoglycoside
- No high level resistance to aminoglycosides
- Ampicillin AND (ceftriaxone OR cefotaxime)
- Meningitis
- Preferred regimen: (Ampicillin 2 g q4h IV for 14 days OR Penicillin G 4 million units q4h IV for 14 days) AND (Gentamycin 2 mg/kg loading dose, followed by 1.7 mg/kg IV q8h OR Streptomycin 7.5 mg/kg body weight q12h (evaluation of drug levels is strongly recommended) for 14 days )
- Urinary tract infection, intra-abdominal infection, pelvic infection, wound infection
- Preferred regimen: Nitrofurantoin 100 mg PO q6h for 5 days OR Fosfomycin 3 g PO (single dose) OR Amoxicillin 875 mg-1 g PO q12h for 5 days
- Neonatal infections
- Skin and soft tissue infections (wound infection)
Prophylaxis
Antimicrobial Regimen
Gallery
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![SEM depicts a small group of Gram-positive Enterococcus faecalis bacteria. From Public Health Image Library (PHIL). [4]](/images/d/d5/Enterococcus08.jpeg)
SEM depicts a small group of Gram-positive Enterococcus faecalis bacteria. From Public Health Image Library (PHIL). [4]
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![Enterococcus faecalis cultured on an agar plate, testing for drug sensitivity in an anaerobic environment. From Public Health Image Library (PHIL). [4]](/images/7/7c/Enterococcus05.jpeg)
Enterococcus faecalis cultured on an agar plate, testing for drug sensitivity in an anaerobic environment. From Public Health Image Library (PHIL). [4]
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![SEM depicts Gram-positive Enterococcus faecalis sp. bacteria. From Public Health Image Library (PHIL). [4]](/images/c/ca/Enterococcus02.jpeg)
SEM depicts Gram-positive Enterococcus faecalis sp. bacteria. From Public Health Image Library (PHIL). [4]
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![Quantitative difference in hemolytic reactivity seen on BAP with group-D Streptococci (left wedge), group-B Streptococci (middle wedge), and group-A Streptococci (right wedge) bacteria. From Public Health Image Library (PHIL). [4]](/images/f/f5/Group_A_streptococcus04.jpeg)
Quantitative difference in hemolytic reactivity seen on BAP with group-D Streptococci (left wedge), group-B Streptococci (middle wedge), and group-A Streptococci (right wedge) bacteria. From Public Health Image Library (PHIL). [4]
![SEM depicts a small group of Gram-positive Enterococcus faecalis bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Enterococcus08.jpeg)
![Enterococcus faecalis cultured on an agar plate, testing for drug sensitivity in an anaerobic environment. From Public Health Image Library (PHIL). [4]](/index.php/File:Enterococcus05.jpeg)
![SEM depicts Gram-positive Enterococcus faecalis sp. bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Enterococcus02.jpeg)
![Quantitative difference in hemolytic reactivity seen on BAP with group-D Streptococci (left wedge), group-B Streptococci (middle wedge), and group-A Streptococci (right wedge) bacteria. From Public Health Image Library (PHIL). [4]](/index.php/File:Group_A_streptococcus04.jpeg)
References
- ↑ 1.0 1.1 1.2 Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. 294&ndash, 5. ISBN 0-8385-8529-9.
- ↑ Pelletier LL (1996). Microbiology of the Circulatory System. in: Baron's Medical Microbiology (Baron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
- ↑ Schleifer KH; Kilpper-Balz R (1984). "Transfer of Streptococcus faecalis and Streptococcus faecium to the genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov". Int. J. Sys. Bacteriol. 34: 31&ndash, 34.
- ↑ 4.0 4.1 4.2 4.3 "Public Health Image Library (PHIL)".