Enterococus Faecalis

Last updated 21/12/18

Definition

• Enterococci commensal gram positive bacteria
• Also known as Streptococcus faecalis

Features

• Gram positive cocci
• Non motile
• Catalase negative
• Faculative anerobes
• Found in human gastrointestinal tract
• Can survive in harsh conditions
• Transmission
• Physcial contact
• Increasing antibiotic resistance
• Vancomycin Resistant Enterococcus (VRE)
• Increasing association with nosocomial infections
• Forms biofilms
• Common pathogen in intravascular devices (central venous catheters (CVC), peripheral cannulas) and urinary cathters (indwelling urinary cathters (IDC), suprapubic catheters (SPC))
• Generally considered a low virulence bacteria

Diseases

• Pneumonia
• Infective endocarditis (IE)
• Meningitis
• Abdominal or pelvic infections
• Urinary tract infections (UTI)
• Pyelonephritis
• Acute cholecystitis
• Peritonitis
• Septic arthritis
• Osteomyelitis
• Wound infection
• Sepsis

Risk Factors

• Immunosupression
• Elderly
• Recent antibiotics
• Gastrointestinal mucosal procedures or instrumentation

Investigations

• Blood cultures (BC)
• Urine MCS
• Wound swab
• Fecal MCS

Management

• Antibiotics
• Ampicillin
• Or Gentamicin
• VRE: guided by sensitivities and infectious diseases physician
• Teicoplanin
• Or Linezolid
• VRE
• Isolation of patient if admitted
• Contact precautions + personal protective equipment (PPE)

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References

1. MSDSonline. Enterococcus faecalis and faecium. 2010
2. Life in the Fast Lane. Vancomycin Resistant Enterococcus (VRE). 08/01/2016.
3. Pic: fineartamerica. Alfred Pasieka