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[Enterococcal infections: from simple to most complex]
Revue Medicale Suisse
|December 3, 2014
Summary
Enterococci infections are a growing concern due to antibiotic resistance. Limiting specific antibiotic use and tailoring treatments based on antibiograms are crucial to combat resistant strains, especially vancomycin-resistant enterococci.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Enterococci, particularly Enterococcus faecalis and Enterococcus faecium, are significant clinical pathogens.
- These bacteria exhibit remarkable adaptability and intrinsic resistance to many antibiotics.
- Rising acquired resistance to penicillins further complicates treatment strategies.
Observation:
- Prior antibiotic exposure, including cephalosporins and quinolones, is a key risk factor for enterococcal colonization and infection.
- Empirical treatment for severe enterococcal infections often involves glycopeptides due to existing resistance patterns.
Findings:
- Enterococci demonstrate significant intrinsic and acquired antibiotic resistance.
- Specific antibiotics like cephalosporins and quinolones are linked to increased risk of enterococcal colonization and infection.
Implications:
- Restricting the empirical use of broad-spectrum antibiotics such as cephalosporins and quinolones is vital.
- Implementing targeted antibiotic therapy guided by antibiogram results is essential.
- These measures are critical to prevent the emergence and spread of resistant enterococcal strains, including vancomycin-resistant enterococci (VRE).
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