Clinical Findings of Enterococci
المؤلف:
Stefan Riedel, Jeffery A. Hobden, Steve Miller, Stephen A. Morse, Timothy A. Mietzner, Barbara Detrick, Thomas G. Mitchell, Judy A. Sakanari, Peter Hotez, Rojelio Mejia
المصدر:
Jawetz, Melnick, & Adelberg’s Medical Microbiology
الجزء والصفحة:
28e , p228-229
2025-08-27
388
Enterococci are commensal bacteria and part of the normal enteric microbiota. E. faecalis and E. faecium are the most commonly isolated enterococcal species causing infections in humans. Other, less frequently encountered enterococci include Enterococcus gallinarum, Enterococcus casseliflavus, and E. raffinosus. Historically, E. faecalis has been recognized as the most commonly isolated species causing 85–90% of enterococcal infections; E. faecium causes 5–10%. However, in recent years these percentages have been changing, recognizing a rise in infections due to E. faecium, particularly as a cause of blood stream infections. In hospitalized patients, the most common sites of infection are the urinary tract, burn and surgical wounds, biliary tract, and blood. Urinary tract infections (UTIs) are by far the most common form of enterococcal infections, and are frequently associated with indwelling catheters, instrumentation, or structural abnormalities of the genitourinary tract. Intraabdominal and pelvic infections are also frequently caused by enterococci. How ever, these infections are often polymicrobial, as are UTIs and wound infections. In such cases, it may be difficult to define the exact pathogenic role of the enterococci in the infection.
Bacteremia and endocarditis are also common forms of enterococcal infections, and are frequently associated with metastatic abscesses and high mortality rates. Infections of the respiratory tract (eg, pneumonia, otitis, and sinusitis) and/or the central nervous system (eg, meningitis) have been described, but occur rarely. Two forms of enterococcal meningitis have been described: spontaneous and postoperative meningitis. Spontaneous meningitis is typically a community-associated infection in patients with severe comorbidities (eg, diabetes, chronic renal failure, and immunosuppression), whereas postoperative meningitis is a hospital-acquired infection (eg, associated with ventricular shunt devices, CNS electrodes). Neonatal infections due to enterococci have also been described. Enterococci are part of the normal adult vaginal microbiota, and can therefore be acquired by neonates during vaginal delivery. Neonatal enterococcal infections are typically late-onset sepsis, pneumonia, but other infections such as UTIs, surgical site infections, and meningitis have also been described.
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