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Medical Microbiology

Medical Microbiology. Chapter 24 Enterococcus. Enterococcus. Entero - coccus - Originally classified as Group D strep 2 important species: Enterococcus faecalis Enterococcus faecium. Physiology and Structure. Gram + cocci in pairs and short chains Catalase -, fermentation

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Medical Microbiology

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  1. Medical Microbiology Chapter 24 Enterococcus

  2. Enterococcus • Entero- • coccus- • Originally classified as Group D strep • 2 important species: • Enterococcusfaecalis • Enterococcusfaecium

  3. Physiology and Structure • Gram + cocci in pairs and short chains • Catalase -, fermentation • Tolerant to high salt concentrations and bile salts • Figure

  4. Pathogenesis • Commensal organisms • Broad range multi-drug antibiotic resistance • Inherent resistance • Acquired resistance • No single potent virulence factor: Colonization and secreted factors

  5. Epidemiology • Inhabit the intestines of humans and animals • E. faecalis colonize the large intestine (107 organisms per gram of feces) and urinary tract • E. faecium colonize similar sites in lesser numbers • Most infections originate from an intestinal site • Transmission also seen person-to-person and through consumption of contaminated food

  6. Clinical diseases • Risk factors for enterococcal infections: • Urinary or intravascular catheterization • Long-term hospitalization with broad-spectrum antibiotics • ~10% of all nosocomial infections • Important life-threatening nosocomial infections are caused by Vancomycin Resistant Enterococci (VRE) • 35-50% mortality rate • Urinary tract infections • Peritonitis • Endocarditis (5-15% of all cases) • Bacteremia • Wound infections and intrabdominal abscesses

  7. Treatment, Prevention, and Control • Antibiotic resistance makes treatment difficult • 25% resistance to the aminoglycoside • 50% resistance to ampicillin • 20% resistance to vancomycin • News Article

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