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Related Experiment Videos

Enterococci: susceptibility patterns and therapeutic options

G Nicoletti1, S Stefani

  • 1Institute of Microbiology, University of Catania, Italy.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|January 1, 1995
PubMed
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Enterococci bacteria are increasingly resistant to antibiotics, posing a significant challenge for treatment. This growing antimicrobial resistance, especially to common drugs, necessitates new therapeutic strategies for enterococcal infections.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Enterococci exhibit pathogenicity through intrinsic antimicrobial resistance rather than common virulence factors.
  • They are intrinsically resistant to beta-lactams, polymyxins, and lincosamides, and tolerant to penicillin and glycopeptide bactericidal activity.
  • Acquired resistance to ampicillin, aminoglycosides, chloramphenicol, and erythromycin is prevalent in many enterococcal strains.

Purpose of the Study:

  • To review the evolving landscape of antibiotic resistance in Enterococcus species.
  • To highlight the clinical implications of multidrug-resistant enterococci.
  • To discuss current and potential therapeutic options for enterococcal infections.

Main Methods:

  • Review of national and international studies on enterococcal antibiotic resistance patterns.

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  • Analysis of resistance mechanisms, including high-level aminoglycoside resistance and beta-lactamase production.
  • Evaluation of current treatment guidelines and limitations.

    • Main Results:

    • Many enterococcal strains display multidrug resistance, notably high-level resistance to streptomycin and gentamicin, rendering synergistic antibiotic combinations ineffective.
    • Emergence of ampicillin-resistant strains, some producing beta-lactamase.
    • Increasing, though still rare, resistance to glycopeptides like vancomycin and teicoplanin is a growing global concern.

    Conclusions:

    • Nosocomial enterococcal isolates demonstrate resistance to nearly all available antimicrobial agents, complicating infection control and treatment.
    • Vancomycin and teicoplanin remain key therapeutic options, but their efficacy against resistant strains requires careful consideration.
    • Optimal treatment regimens for infections caused by multidrug-resistant enterococci are still under investigation, emphasizing the need for further research.