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Wikipedia - Enterococcus

Enterococcus
Enterococcus sp. infection in pulmonary tissue.
Scientific classification
Kingdom: Bacteria
Division: Firmicutes
Class: Bacilli
Order: Lactobacillales
Family: Enterococcaceae
Genus: Enterococcus
(ex Thiercelin & Jouhaud 1903)
Schleifer & Kilpper-Bälz 1984
Species

E. avium
E. durans
E. faecalis
E. faecium
E. solitarius
etc.
Enterococcus
Classification and external resources
ICD-9 041.04

Enterococcus is a genus of lactic acid bacteria of the phylum Firmicutes. 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.[1] Two species are common commensal organisms in the intestines of humans: E. faecalis (90-95%) and E. faecium (5-10%). There are rare clusters of infections with other species including E. casseliflavus, E. raffinosus.[1]

Contents

[edit] Physiology and classification

Enterococci are facultative anaerobic organisms, i.e., they do not require oxygen for metabolism, but can survive in oxygen-rich environments.[2] Though they are not capable of forming spores, enterococci are tolerant of a wide range of environmental conditions: extreme temperature (10-45°C), pH (4.5-10.0) and high sodium chloride concentrations.[3]

Enterococci typically exhibit gamma-hemolysis on sheep's blood agar.[4]

[edit] History

Members of the genus Enterococcus were classified as Group D Streptococcus until 1984 when genomic DNA analysis indicated that a separate genus classification would be appropriate.[5]

[edit] Pathology

Important clinical infections caused by Enterococcus include urinary tract infections, bacteremia, bacterial endocarditis, diverticulitis, and meningitis.[3][4] Sensitive strains of these bacteria can be treated with ampicillin and vancomycin.[6]

From a medical standpoint, the most important feature of this genus is the high level of endemic antibiotic resistance. Some enterococci are intrinsically resistant to ß-lactam-based antibiotics (some penicillins and virtually all cephalosporins) as well as many aminoglycosides.[4] In the last two decades, particularly virulent strains of Enterococcus that are resistant to vancomycin (Vancomycin-resistant enterococcus, or VRE) have emerged in nosocomial infections of hospitalized patients especially in the US.[3] Other developed countries such as the UK have been spared this epidemic, and, in 2005, Singapore managed to halt an epidemic of VRE. VRE may be treated with quinupristin/dalfopristin (Synercid) with response rates of approximately 70%.[7]

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.[8]

[edit] Water quality

In bodies of water, the acceptable level of contamination is very low, for example in the state of Hawaii, with among the strictest tolerances in the United States, the limit for water off its beaches is 7 colony-forming units per 100 ml of water, above which the state may post warnings to stay out of the ocean.[9] In 2004, Enterococcus spp. took the place of fecal coliform as the new federal standard for water quality at public beaches. It is believed to provide a higher correlation than fecal coliform, with many of the human pathogens often found in city sewage.[10]

[edit] References

  1. ^ a b Gilmore MS, et al, ed (2002). The Enterococci: Pathogenesis, Molecular Biology, and Antibiotic Resistance. Washington, D.C.: ASM Press. ISBN 9781555812348. 
  2. ^ Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JI, ed (2000). Gram-Positive Pathogens. ASM Press. ISBN 1-55581-166-3. 
  3. ^ a b c Fisher K, Phillips C (June 2009). "The ecology, epidemiology and virulence of Enterococcus". Microbiology 155 (Pt 6): 1749–57. doi:10.1099/mic.0.026385-0. PMID 19383684. 
  4. ^ a b c Ryan KJ, Ray CG, ed (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 294–5. ISBN 0-8385-8529-9. 
  5. ^ 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: 31–34. 
  6. ^ Pelletier LL Jr. (1996). Microbiology of the Circulatory System. in: Baron's Medical Microbiology (Baron S et al., eds.) (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.5077. 
  7. ^ Tünger A, Aydemir S, Uluer S, Cilli F (2004). "In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci". Indian J Med Res 120 (6): 546–52. PMID 15654141. 
  8. ^ Guardado R, Asensi V, Torres JM, et al. (2006). "Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases". Scand. J. Infect. Dis. 38 (8): 584–8. doi:10.1080/00365540600606416. PMID 16857599. 
  9. ^ "Clean Water Branch". Hawaii State Department of Health. http://www.hawaii.gov/health/environmental/water/cleanwater/index.html. Retrieved 2007-02-08. 
  10. ^ Jin G, Jeng HW, Bradford H, Englande AJ (2004). "Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment". Water Environ. Res. 76 (3): 245–55. doi:10.2175/106143004X141807. PMID 15338696. 
v • d • e
Firmicutes (low-G+C) Infectious diseases · Bacterial diseases: G+ (primarily A00–A79, 001–041, 080–109)
Bacilli
Enterococcus
Clostridia
Clostridium (spore-forming)
Peptostreptococcus (non-spore forming)
Mollicutes

M: BAC

drug(J1p, w, n, m, vacc)
Retrieved from "http://en.wikipedia.org/wiki/Enterococcus"

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Enterococcus".

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