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Enterococcus
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Enterococcus
Enterococcus is a large genus of lactic acid bacteria of the phylum Bacillota. Enterococci are Gram-positive cocci that often occur in pairs (diplococci) or short chains, and are difficult to distinguish from streptococci on physical characteristics alone. Two species are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare clusters of infections occur with other species, including E. durans, E. casseliflavus, E. gallinarum, and E. raffinosus.
Enterococci are facultative anaerobic organisms, i.e., they are capable of cellular respiration in both oxygen-rich and oxygen-poor environments. Though they are not capable of forming spores, enterococci are tolerant of a wide range of environmental conditions: extreme temperature (10–45 °C), pH (4.6–9.9), and high sodium chloride concentrations.
E. faecium and E. faecalis can be differentiated based on their carbohydrate metabolism: E. faecium consistently metabolizes lactose but not melezitose or inositol, whereas E. faecalis reliably metabolizes sorbitol and sucrose but lacks the ability to utilize L-arabinose, melibiose, or raffinose. Less is known of other species; E. durans share most of the important carbohydrate metabolism with E. faecium.
Enterococci exhibit variable hemolysis on blood agar. Differences occur between species, and between strains of species. More virulent organisms are more likely to exhibit alpha (partial) or beta (complete) hemolysis than less virulent specimens of Enterococcus, which frequently exhibit gamma (absent) hemolysis.
Members of the genus Enterococcus (from Greek έντερο, éntero 'intestine' and κοκκος, coccos 'granule') were classified as group D Streptococcus until 1984, when genomic DNA analysis indicated a separate genus classification would be appropriate.
This genus appears to have evolved 425 million years ago to 500 million years ago.
Important clinical infections caused by Enterococcus include urinary tract infections (see Enterococcus faecalis), bacteremia, bacterial endocarditis, diverticulitis, meningitis, and spontaneous bacterial peritonitis. Sensitive strains of these bacteria can be treated with ampicillin, penicillin and vancomycin. In catheterized patients receiving intensive care, Enterococcus spp., have been reported the dominant cause of urinary tract infections, particularly in patients treated with cephalosporin antibiotics. Recent work has shown that multiple genetically distinct Enterococcus sequence types, including antibiotic resistant and high risk clones, can coexist in the same urine sample from a single ICU patient, with the more virulent lineage often present only as a minority subpopulation - undetectable by standard diagnostics. Urinary tract infections can be treated specifically with nitrofurantoin, even in cases of vancomycin resistance.
Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous or intrathecal vancomycin, yet it is debatable as to whether its use has any impact on outcome: the removal of any neurological devices is a crucial part of the management of these infections. New epidemiological evidence has shown that enterococci are major infectious agent in chronic bacterial prostatitis. Enterococci are able to form biofilm in the prostate gland, making their eradication difficult.[citation needed] Cases of enterococcal meningitis, in the absence of trauma or surgery, should raise suspicion of an underlying intestinal pathology (e.g., strongyloidiasis).
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Enterococcus
Enterococcus is a large genus of lactic acid bacteria of the phylum Bacillota. Enterococci are Gram-positive cocci that often occur in pairs (diplococci) or short chains, and are difficult to distinguish from streptococci on physical characteristics alone. Two species are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare clusters of infections occur with other species, including E. durans, E. casseliflavus, E. gallinarum, and E. raffinosus.
Enterococci are facultative anaerobic organisms, i.e., they are capable of cellular respiration in both oxygen-rich and oxygen-poor environments. Though they are not capable of forming spores, enterococci are tolerant of a wide range of environmental conditions: extreme temperature (10–45 °C), pH (4.6–9.9), and high sodium chloride concentrations.
E. faecium and E. faecalis can be differentiated based on their carbohydrate metabolism: E. faecium consistently metabolizes lactose but not melezitose or inositol, whereas E. faecalis reliably metabolizes sorbitol and sucrose but lacks the ability to utilize L-arabinose, melibiose, or raffinose. Less is known of other species; E. durans share most of the important carbohydrate metabolism with E. faecium.
Enterococci exhibit variable hemolysis on blood agar. Differences occur between species, and between strains of species. More virulent organisms are more likely to exhibit alpha (partial) or beta (complete) hemolysis than less virulent specimens of Enterococcus, which frequently exhibit gamma (absent) hemolysis.
Members of the genus Enterococcus (from Greek έντερο, éntero 'intestine' and κοκκος, coccos 'granule') were classified as group D Streptococcus until 1984, when genomic DNA analysis indicated a separate genus classification would be appropriate.
This genus appears to have evolved 425 million years ago to 500 million years ago.
Important clinical infections caused by Enterococcus include urinary tract infections (see Enterococcus faecalis), bacteremia, bacterial endocarditis, diverticulitis, meningitis, and spontaneous bacterial peritonitis. Sensitive strains of these bacteria can be treated with ampicillin, penicillin and vancomycin. In catheterized patients receiving intensive care, Enterococcus spp., have been reported the dominant cause of urinary tract infections, particularly in patients treated with cephalosporin antibiotics. Recent work has shown that multiple genetically distinct Enterococcus sequence types, including antibiotic resistant and high risk clones, can coexist in the same urine sample from a single ICU patient, with the more virulent lineage often present only as a minority subpopulation - undetectable by standard diagnostics. Urinary tract infections can be treated specifically with nitrofurantoin, even in cases of vancomycin resistance.
Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous or intrathecal vancomycin, yet it is debatable as to whether its use has any impact on outcome: the removal of any neurological devices is a crucial part of the management of these infections. New epidemiological evidence has shown that enterococci are major infectious agent in chronic bacterial prostatitis. Enterococci are able to form biofilm in the prostate gland, making their eradication difficult.[citation needed] Cases of enterococcal meningitis, in the absence of trauma or surgery, should raise suspicion of an underlying intestinal pathology (e.g., strongyloidiasis).
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