Enterococcus

Enterococcus By Richard Guilford Enterococcus Enterococcus, or to a greater extent appropriately enterococci, are a family of bacteria in the division firmicutes (meaning strong skin and referring to the cell wall) and the class bacilli (which refers to its rod akin shape). They look just like streptococcus bacteria from physical device characteristics alone. In fact, members of the genus Enterococcus were classified as Group D streptococci until 1984 when genomic DNA depth psychology showed that a separate genus classification would be appropriate.Enterococci are part of the pattern intestinal flora (good bacteria) of humanes and animals but are also crucial pathogens responsible for serious infections. They are considered gram-positive, meaning they stain dark black or violet. They also or soly occur in pairs or pitiable chains. Enterococci are facultative anaerobic organisms, meaning they provide thrive in both oxygen rich and oxygen poor environments. They do not form s pores as some(prenominal) bacteria do, meaning they do not drive home a reproductive structure that is adapted for dispersal and survival for extended periods of time in unfavorable conditions.Nevertheless, they are tolerant of a wide range of environmental conditions much(prenominal) as extreme temperature (10-45C), pH (4. 5-10. 0) and richly sodium chloride concent ration. In bodies of body of water, the acceptable level of contamination is very(prenominal) low, for example in the state of Hawaii, with among the strictest tolerances in the United States, the limit for water off its beaches is 7 colony-forming units per 100 ml of water. Anything above that, the state whitethorn post warnings to stay out of the ocean. In 2004, Enterococcus spp. took the place of fecal coliform as the new federal standard for water quality at globe beaches.It is believed to provide a higher correlation than fecal coliform with many a(prenominal) of the human pathogens a good deal ground in city sewage (eww right? ). in that respect are many strains of enterococcus. Important clinical infections ca dropd by Enterococcus include urinary tract infections, bacteremia, bacterial endocarditis, diverticulitis, and meningitis. Sensitive strains of these bacteria weed be treat with ampicillin and vancomycin, two tumesce known and ofttimes used antibiotics. An consequential feature of enterococcus is the high level of intrinsic antibiotic resistance, meaning its constitutional ability to ithstand some of the more common antibiotics. Some enterococci are per se resistant to beta-lactam- ground antibiotics (those include some penicillins and virtually all cephalosporins) as well as many aminoglycosides (an amino-sugar that can sometimes function as an antibiotic). In the last two decades, particularly virulent strains of enterococcus that are resistant to vancomycin (vancomycin-resistant Enterococcus, or VRE) have emerged in nosocomial (infections caught in infirmarys whil e supervise is being given) infections of hospitalized patients particularly in the US.Other developed countries such as the UK have been spared this epidemic, and, in 2005, Singapore managed to halt an epidemic of VRE. VRE may be treated with quinupristin/dalfopristin (a special antibiotic developed to fight VRE) or Synercid with retort rates of approximately 70%. Enterococcus avium is a species that is most commonly name in birds. Rarely, it is also a cause of infection in humans, and in such cases, may be vancomycin-reistant. It is referred to as VREA. VREA cases in humans have been successfully treated with linezolid (a synthetic antibiotic).Enterococcus durans and enterococcus faecalis are very similar. They are often mistaken for one another in determining infections. They inhabit the gastrointestinal tracts of humans and other mammals. It is among the main parts of some probiotic food supplements. homogeneous other species in the genus enterococcus, E. faecalis can cause life- flagellumening infections in humans, especially in the nosocomial environment. The naturally high levels of antibiotic resistance lay down in E. faecalis contribute to its ability to infect.E. faecalis has been frequently found in take root canal-treated teeth in prevalence values ranging from 30% to 90% of the cases. spreadeagle canal-treated teeth are about nine times more presumable to have E. faecalis than cases of primary infections. Enterococcus faecium is an alpha hemolitic or nonhemolitic, bacterium. It is used as a probiotic in animals. It can be commensal (a harmlessly coexisting organism) in the human intestine, but it may also be pathogenic, causing diseases such as neonatal meningitis.Enterococcal meningitis is also a rare complication of neurosurgery. It often requires treatment with IV or intrathecal (something introduced into or occurring in the space on a lower floor the arachnoid membrane of the brain or spinal cord) vancomycin, yet it is groping wheth er its use has any impact on outcome. The removal of any neurologic devices is an important part of the management of these infections. Enterococcus solitarius and Enterococcus gallinarum are two more species of enterococcus.The genus Enterococcus includes more than 17 species, but only a few cause clinical infections in humans. Infection control programs were created three decades ago to control antibiotic-resistant nosocomial infections, but there has been little evidence of control in most facilities. later long, steady increases of MRSA and VRE infections in hospitals, the Society for Healthcare Epidemiology of America (SHEA) come on of Directors made reducing antibiotic-resistant infections a strategic SHEA goal in January 2000.After 2 more years without improvement, a SHEA task force was official to draft an evidence-based guideline on preventing nosocomial transmission of pathogens, focusing on the two considered most out of control MRSA and VRE. Medline searches were con ducted spanning 1966 to 2002. Many interpretations of unpublished studies providing commensurate data were included. Frequent antibiotics in healthcare settings provided a small favor for resistant strands, but patients with MRSA or VRE usually acquire it through spread. The CDC has long-recommended contact lens precautions for patients colonized or infected with these pathogens.Most facilities have required this as policy, but have not actively identified infected patients with command cultures (lab tests performed to determine possible abnormalities or infection) and tests, leaving most infected patients undetected and not isolated. Many studies have shown control of endemic (exclusively native to a place) and/or epidemic (everywhere) MRSA and VRE infections using surveillance cultures and contact precautions. Active surveillance cultures are essential to identify the infected to prevent spread of MRSA and VRE infections and pack control possible using the CDCs long-recommen ded contact precautions.Testing for enterococci can be tricky. Enterococci have been recognized to be of fecal origin since the offset printing of this century. The usual ecological home for the Enterococcus species is the intestines of humans and other animals. However, enterococci are present (present everywhere) and can be found free-living in soil, on plants, or in dairy products. Enterococcus comprises gram-positive cocci that are catalase (a common enzyme found in nearly all living organisms that are exposed to oxygen, where it functions to change state the decomposition of hydrogen peroxide to water and oxygen) negative, usually facultative anaerobic acteria. There is clear evidence of the genotypic (concerning the genetic makeup) identity of Enterococcus, based on molecular studies. Enterococci have also been related to human diseases, go established as major nosocomial pathogens. The isolation of strains resistant to many antibiotics has become important in public healt h concerns. In addition, Enterococcus and Streptococcus have been proposed as indicators of fecal contamination in water because of their high abundance in feces and their long survival in the environment.Although the ratio of fecal coliforms to fecal streptococci has been ruled out as an indicator, the identi? cation of species associated with a given environment or host might provide excess information about the origin and the source of fecal contamination. The ability of enterococci to uprise under particular conditions is widely used in their selective identification. This characteristic allows the detection and enumeration of enterococci with a selective medium (template used to evoke bacteria) M-enterococcus agar or KF streptococcus agar, and by using bile-esculin-azide agar (another medium) as a further test for con? mation. Although this approach can chance upon Enterococci from other bacterial species, some may be identi? ed wrongly. The use of these media can hurt eithe r selectivity (choices of bacteria found) or productivity (ability for bacteria to grow). Even though this approach was to identify enterococci species, it is unsuitable for the detection of true enterococci species because they do not grow on these media. In addition, other bacterial species such as Streptococcus are able to grow on the media, presenting results similar to those of Enterococci.Enterococci are diverse and enigmatic. There are many strains and many complications that can arise from them. They are both harmless and deadly, useful and destructive. They can be used to aid digestion, or feared in a hospital setting. They are indeed a medical paradox. With continued study, we hope to engage from and understand these bacteria if not to aid us in our expanding upon of knowledge, then to rid us of a potentially critical threat in our hospital settings. Gilmore MS, (2002). The Enterococci Pathogenesis, Molecular Biology, and Antibiotic Resistance.Fisher K, Phillips C (June 2009). The ecology, epidemiology and malignity of Enterococcus. Jin G, Jeng HW, Bradford H, Englande AJ (2004). Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment. Carlene A. Muto, MD, MS pot A. Jernigan, MD, MS Belinda E. Ostrowsky, MD, MPH Herve M. Richet, MD William R. Jarvis, MD John M. Boyce, MD Barry M. Farr, MD, MSc (May 2003). SHEA Guideline for Preventing Nosocomial Transmission of Multidrug-Resistant Strains of Staphylococcus aureus and Enterococcus