Enterococcus
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Bacteria - Gram Positive
- Staph aureus: Overview
- Staph aureus: Presentation
- Methicillin-Resistant Staph aureus (MRSA)
- Staph saprophyticus
- Strep pneumoniae: Overview
- Strep pneumoniae: Presentation
- Strep viridans
- Strep pyogenes: Overview
- Strep pyogenes: Presentation
- Strep agalactiae
- Strep bovis
- Enterococcus
- Bacillus anthracis
- Bacillus cereus
- Clostridium tetani
- Clostridium perfringens
- Clostridium botulinum
- Clostridium difficile
- Corynebacterium diphtheriae
- Listeria monocytogenes
- Nocardia
- Actinomyces
Enterococci
- E faecalis and E faecium
- Gram + cocci in pairs (diplococci) or short chains
- Difficult to distinguish vs. streptococci by physical characteristics alone
- Catalase –
- PYR +
- Gamma (not) Hemolytic
- Rarely can be alpha-hemolytic
- Highly resilient
- can grow in hypertonic (6.5%) NaCl and bile
- Presentation generally follows GI/GU procedures
- Part of normal intestinal and urogenital flora, introduced to bloodstream following procedures (foley catheter, cystoscopy, colonoscopy)
- UTI
- Most common infection caused by enterococcus
- Biliary tract infection
- Related to its ability to grow in bile
- Subacute endocarditis
- VRE (vancomycin-resistant enterococci)
- important cause of nosocomial infection
- Alters the vancomycin-binding site from a D-alanyl-D-alanine terminus to a D-alanine-D-lactate terminus
- Resistance gained through uptake of resistance plasmid
- Treatment is dependent on susceptibility testing:
- Amoxicillin, fosfomycin, or nitrofurantoin for UTI
- Ampicillin, vancomycin, daptomycin for sepsis
- Ampicillin and gentamicin for endocarditis
- Linezolid for VRE