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Antibiotic heteroresistance and persistence: an additional aid in hospital acquired infections by Enterococcus spp.?
Catarina Geraldes1,2, Luís Tavares1,2, Solange Gil1,2,3
1CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
Abstract:
Enterococcus, particularly E. faecium and E. faecalis, are responsible for many hospital-acquired infections. With their intrinsic antibiotic resistance and ability to form biofilms, enterococcal infections are already challenging to manage. However, when heterogenous populations are present, such as those exhibiting heteroresistance and persistence, the complexity of these infections increases exponentially not only due to their treatment but also due to their difficult diagnosis. In this study, we provide a summary of the current understanding of both heteroresistance and persistence in terms of mechanisms, diagnosis and treatment and subsequently review recent literature pertaining to these susceptibility types specifically in enterococci.
Insights
Hospital-acquired enterococcal infections are complicated by heteroresistance and persistence. This review summarizes mechanisms, diagnosis, and treatment strategies for these challenging bacterial traits in Enterococcus species.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Enterococcus species, particularly E. faecium and E. faecalis, are significant causes of hospital-acquired infections.
- Intrinsic antibiotic resistance and biofilm formation in Enterococcus complicate treatment.
- Heteroresistance and persistence in Enterococcus populations further increase diagnostic and therapeutic challenges.
Purpose of the Study:
- To summarize the current understanding of heteroresistance and persistence in Enterococcus.
- To review mechanisms, diagnosis, and treatment of these complex susceptibility phenotypes.
- To highlight recent literature on heteroresistance and persistence in enterococci.
Main Methods:
- Literature review and synthesis of existing research.
- Focused analysis on Enterococcus species, E. faecium, and E. faecalis.
- Examination of mechanisms, diagnostic approaches, and treatment strategies.
Main Results:
- Heteroresistance and persistence represent complex bacterial subpopulations within Enterococcus.
- These phenotypes contribute to treatment failures and diagnostic difficulties.
- Current literature reveals ongoing research into the molecular basis and clinical implications.
Conclusions:
- Understanding heteroresistance and persistence is crucial for managing enterococcal infections.
- Further research is needed to develop effective diagnostic and therapeutic interventions.
- Targeting these specific bacterial traits may improve patient outcomes in healthcare settings.
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