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Multidrug-Resistant Enterococcal Infection in Surgical Patients, What Surgeons Need to Know
Soroush Farsi1, Ibrahim Salama1, Edgar Escalante-Alderete1
1Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
Abstract:
Enterococci are organisms that can be found in the normal intestinal and skin microbiota and show remarkable ability to acquire antibiotic resistance. This is an enormous challenge for surgeons when faced with surgical site infections caused by multidrug-resistant (MDR) Enterococci. Due to an increase in the prevalence of MDR Enterococcus within the last few decades, there has been a major decrease in therapeutic options, because the majority of E. faecium isolates are now resistant to ampicillin and vancomycin and exhibit high-level resistance to aminoglycosides, traditionally three of the most useful anti-enterococcal antibiotics. There is limited data regarding the magnitude and pattern of multidrug resistance among the enterococcal genus causing surgical site infections in hospitalized patients. The scope of the review is to summarize the most recent findings in the emergence of postoperative MDR Enterococci and discuss recent mechanisms of resistance and the best treatment options available.
Insights
Multidrug-resistant (MDR) Enterococci pose a significant threat in surgical site infections, limiting treatment options. This review examines emerging resistance patterns and effective therapeutic strategies against these challenging pathogens.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Enterococci are common microbiota with a high capacity for acquiring antibiotic resistance.
- Multidrug-resistant (MDR) Enterococci present a major challenge for surgical site infections (SSIs).
- Increasing resistance to ampicillin, vancomycin, and aminoglycosides in *E. faecium* severely restricts therapeutic choices.
Purpose of the Study:
- To review the emergence and patterns of MDR Enterococci in postoperative infections.
- To discuss current mechanisms of antibiotic resistance in Enterococci.
- To outline the most effective treatment options for MDR Enterococci SSIs.
Main Methods:
- Literature review of recent findings on MDR Enterococci in surgical site infections.
- Analysis of resistance mechanisms.
- Evaluation of current treatment strategies.
Main Results:
- Significant increase in MDR Enterococci prevalence in hospital settings.
- Detailed overview of genetic and non-genetic resistance mechanisms.
- Identification of limited but viable treatment options.
Conclusions:
- MDR Enterococci are a growing concern in SSIs, necessitating updated treatment guidelines.
- Understanding resistance mechanisms is crucial for developing new therapeutic approaches.
- Prompt identification and appropriate management are key to improving patient outcomes.
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