Enterococcus faecalis infection

A third case of intramuscular ricin injection involved a 53 year-old male who injected part of 13 chewed castor beans into his thigh with suicidal intent (Passeron et al., 2004). He developed necrotic cellulitis complicated by Enterococcus faecalis infection requiring emergency surgical debridement, but recovered after three months hospitalization. 

Urinary tract infections (complicated and uncomplicated) - Enterococcus faecalis, S. awrews (penicillinase-producing), E. coli, Klebsiella sp.,... 

Intra-abdominal Infections - Enterococcus faecalis, S. aureus (penicillinase-producing), Staphylococcus epidermidis, E. coli, Klebsiella sp., Enterobacter sp., Proteus sp., M. morganii, P. aeruginosa, Citrobactersp., Clostridium sp., Bacteroides sp. including Bacteroides fragilis, Fusobacterium sp. Peptococcus sp., Peptostreptococcus sp., Eubacterium sp., Proplonibacterium sp.. Bifidobacterium sp. 

Gram-positive cocci Enterococcus faecalis Endocarditis or other serious infection (bacteremia] Ampicillin or penicillin G + gentamicin or streptomycin Vancomycin + gentamicin or streptomycin... 

Enterococcus faecalis Urinary tract infection Ampicillin or amoxicillin Ciprofloxacin doxycycline levofloxacin fosfomycin... 

This patient was treated empirically with vancomycin alone because his physicians suspected that he had endocarditis, caused by Streptococcus of the viridans group. The history indicated that the origin of the infection was the patient s mouth. Three days later the results from the clinical microbiology laboratory showed that three blood cultures, taken at the time of admission, grew Enterococcus faecalis. susceptible to ampicillin, vancomycin, gentamicin, and streptomycin. 

Daptomycin has proven efficacy in a number of in vivo animal models, including soft tissue infections by MRSA, bacteraemia caused by S. aureus or vancomycin-resistant enterococci (VRE), Enterococcus faecalis pyelonephritis, MRSA osteomyelitis, MRSA and Bacillus anthracis pulmonary infections, Gram-positive endocarditis, Clostridium difficile colitis and S. pneumoniae and S. aureus meningitis.9,64 66... 

Enterococcus faecalis (Group D) benzylpenicillin 1.8-3g 4-hourly plus gentamicin i.v. for 4-6 weeks. The prolonged gentamicin administration carries a significant risk of adverse drug reactions, but is essential to assure eradication of the infection. 

A 53-year-old white woman with liver cirrhosis took vancomycin (1 g bd) for sepsis due to methicillin-resistant S. aureus and a catheter-associated infection due to Enterococcus faecalis, developed oral and vaginal mucositis and conjunctivitis followed by a macu-lopapular rash (69). The diagnosis was confirmed by skin biopsy. Vancomycin was replaced by teicoplanin and corticosteroids the symptoms disappeared within 7 days. 

Houlihan HH, Stokes DP, Rybak MJ. Pharmacodynamics of vancomycin and ampicilUn alone and in combination with gentamicin once daily or thrice daily against Enterococcus faecalis in an in vitro infection model. J Antimicrob Chemother 2000 46 79-86. 

Wells VD, Wong ES, Murray BE, et al. Infections due to beta-lactamase-producing, high-level gentamicin-resistant Enterococcus faecalis. Ann Intern Med 1992 116 285-292. 

Eighty-five percent of uncomplicated urinary tract infections are caused by Escherichia coli, and the remainder are caused primarily by Staphylococcus saprophyticus, Proteus spp., and Klebsiella spp. Complicated infections are more frequently associated with gram-negative organisms and Enterococcus faecalis. 

Aarestrup FM, Agerso Y, Gemer-Smidt P, Madsen M, Jensen LB (2000) Comparison of antimicrobial resistance phenotypes and resistance genes in Enterococcus faecalis wnd Enterococcus faecium from humans in the community, broilers, and pigs in Denmark. Diagn Microbiol Infect Dis... 

Chiew YF, Hall LM (1998) Comparison of three methods for the molecular typing of Singapore isolates of enterococci with high-level aminoglycoside resistances. J Hosp Infect 38 223-230 Clewell DB (1993) Bacterial sex pheromone-induced plasmid transfer. Cell 73 9-12 Coburn PS, Gilmore MS (2003) The Enterococcus faecalis cytolysin a novel toxin active against eukaryotic and prokaryotic cells. Cell Microbiol 5 661-669... 

Ebringer L, Ferenclk M, Lahitova N, Kacani L, Michalkovi D (1995) Antimutagenic and immunos-timulatory properties of lactic acid bacteria. World J Microbiol Biotechnol 11 294-298 Eisner HA, Sobottka 1, Mack D, Claussen M, Laufs R, Wirth R (2000) Virulence factors of Enterococcus faecalis and Enterococcus faecium blood culture isolates. Eur J Clin Microbiol Infect Dis 19 39-42... 

Engelbert M, Mylonakis E, Ausubel EM, Calderwood SB, Gilmore MS (2004) Contribution of gelatinase, serine protease, and/srto the pathogenesis of Enterococcus faecalis endophthalmitis. Infect Immun 72 3628-3633... 

Su A, Sulavik MC, He P, Makinen KK, Makinen P, Fiedler S, Wirth R, Clewell DB (1991) Nucleotide sequence of the gelatinase gene igelE) from Enterococcus faecalis subsp. Liquefaciens Infect Immun 59 415 20... 

SiiBmuth SD, MuschoU-SUberhom A, Wirth R, Susa M, Marre R, Rozdzinski E (2002) Aggregation substance promotes adherence, phagocytosis, and intracellular survival of Enterococcus faecalis within human macrophages and suppresses respiratory burst. Infect Immun 68 4900-4906... 

Chlorhexidine initially was used as a general disinfectant because of its broad antibacterial action (9). It was later shown to inhibit dental caries and reduce the formation of dental plaque (10). In vitro inhibition studies have shown chlorhexidine to be effective against species found in infected root canals such as Enterococcus faecalis (11) and Streptococcus mutans (12), and because of this, it was introduced as an endodontic irrigant in the early 1960 s (10). Chlorhexidine is increasingly being incorporated into endodontic materials due to its ability to increase antimicrobial properties and improve prognosis. 

Figure 14.4 (a) In vivo efficacy of optimized ADEPs. Treatment of lethal systemic infections in mice caused by Enterococcus faecalis with a single dose of antibiotic (amounts indicated). Untreated control animals died within 24 h of infection. Survival is depicted 5 days after infection. (Reprinted by permission from Macmillan Publisher Ltd Nature Medicine [6], copyright 2005.) (b)... 

Like the battle against viruses, the war to stop bacterial and parasitic infections has reached the critical stage, with multidrug-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecalis (VRE), killing thousands of people annually in the United States [196]. Likewise, tuberculosis (TB) has killed about 1 billion people worldwide over the past two centuries. Some 3.5 milUon people in India are currently infected with TB [197]. 

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