Enterococcal Disease, Epidemiology, and Treatment

摘要: Enterococci are associated with a variety of different clinical syndromes, including bacteremias, endocarditis, and urinary tract infections. The emergence resistance has made clinicians keenly aware this organism, previously considered nonpathogen except in certain circumstances. Molecular methods have helped delineate the epidemiology enterococci to vancomycin (VRE) demonstrate nosocomial acquisition transmission among patients. risk serious VRE infection is increased patients neutropenia transplant recipients, as well receiving antimicrobial therapy. Both severity mucositis concomitant Clostridium difficile for bacteremia neutropenic Infection control efforts prudent use antimicrobials essential limiting spread VRE. Treatment enterococcal disease requires synergistic combination cell wall agent an aminoglycoside. few agents that available treat often ineffective or poorly tolerated, making treatment challenging. Given limitations therapy, removal infected foci, such intravenous catheters, drainage abscesses important adjunctive measures. Newer agents, quinupristin/dalfopristin linezolid, proven efficacious although already been reported. Eventually, decolonization drugs ramoplanin may help eliminate gastrointestinal (GI) reservoir