Filamer Christian University

Graduate School
Roxas City Capiz
Extension Classes @
Garcia College of Technology
Kalibo, Aklan

MICROBIOLOGY
SCI. 413

MARJORIE ROSE Z. TEODOSIO MARK ANTHONY A. DURANA

MAT-GEN. SCI. STUDENT COURSE INSTRUCTOR

ENTEROCOCCUS

Enterococci are gram-positive, catalase-negative, non-spore forming and facultative anaerobic

bacteria, which is usually inhabit the alimentary tract of humans in addition to being isolated from
environmental and animal sources. They are able to survive a range of stresses and hostile
environments, including those extreme temperature and high NaCl concentration. They have been
long recognized as important human pathogens and are becoming increasingly so. The genus
Enterococcus includes more than 17 species, although only a few cause clinical infections in humans.
I. BACKGROUND OF THE MICROORGANISMS
For many years Enterococci species where believed to be harmless to humans and considered
unimportant medically because they produce bacteriocins. Enterococcus species have been used
widely over the last decade in the food industry as probiotics or as starter cultures. Recently,
enterococci have become one of the most common nosocomial pathogens, with patients having a
high mortality rate up to 61%. The ability of Enterococcus species to survive a range of adverse
environments allows multiple routes of cross-contamination of enterococci in causing human disease,
including those from food, environmental and hospital sources.

In 2005 there were 7066 reported cases of bacteraemia caused by Enterococcus species in the
UK, an 8% increase from 2004, with the Health Protection Agency stating that “an increase in a
bacteraemia causing pathogen like this has not been observe for some time”. Twenty-eight percent of
all cases were antibiotic resistant. The risk of death from vancomycin-resistant enterococci (VRE) is
75%, compared with 45% for those infected with a susceptible strain. This dramatic increase of
antibiotic resistance of Enterococcus species worldwide highlights the need for a greater
understanding of this genus, including its ecology.

Overall, greater to understanding of the ability of Enterococcus species to survive stresses, of

virulence traits, and especially of increasing antibiotic resistance, is needed in order to fully
appreciate the complexity of Enterococcus species in causing disease.
II. Common Contacted Diseases
Enterococci infections or diseases in humans are mainly caused by E. faecalis and E. faecium
and less commonly by other enterococcal species. Its common contacted diseases includes Urinary
Tract Infection (UTI), Bacteremia, Endocarditis, Intra- Abdominal, Pelvic, and Soft Tissue Infections.
Urinary Tract Infections (UTI)
The most common type of enterococcal infection occurs in the urinary tract. Lower urinary tract
infections (such as cystitis, prostatitis, and epididymitis) are frequently seen in older men. However,
enterococci are exceedingly uncommon as a cause of uncomplicated cystitis in young women. Upper
urinary tract infections that can lead to bacteremia occur, most often in older men. Enterococcal
urinary tract infections are more likely to be acquired in hospital or long-term care settings, and thus,
are more likely to be resistant to many antibiotics. In the ICU setting, enterococci cause almost 15%
of healthcare- associated urinary tract infections.

Bacteremia
Bacteria is usually transient presence of bacteria in the blood wherein Enterococci are
currently the second leading cause of healthcare-associated bacteremia. In the last few years, the
source of a bacteremia is usually the genitourinary tract, although a bacteremia also often arises from
intra-abdominal or biliary sources, indwelling central lines or soft tissue infections. Enterococci are
found as a component of polymicrobial bacteremia more often than other organisms.

Endocarditis
Endocarditis is the inflammation of the lining of the heart and its valves. It is also one of the
most serious enterococcal infections Because of the enterococci’s intrinsic resistance to the
bactericidal activity of most antibiotics, treatment is difficult, even when relatively susceptible
enterococci are involved. Two drugs exhibit synergistic killing are required for effective therapy. In the
situations of VRE or high-level aminoglycoside-resistant enterococcal endocarditis, antibiotic
treatment often fails, and surgery to remove the infect valve is essential.
The initial source of bacteremia leading to endocarditis is usually the genitourinary or
gastrointestinal (GI) tract. The most problematic current issue in the management of enterococcal
endocarditis is the selection of effective therapy for multidrug-resistant isolates.

Intra-Abdominal, Pelvic and Soft Tissue Infection

Enterococci are often recovered from cultures of intra-abdominal, pelvic, and soft tissue
infections. They are almost always isolated a sonly one component of mixed microbial flora and rarely
cause monomicrobial infection at these sites. The importance of enterococci in wounds and
abscesses has been debated at length. However, with enterococcal bacteremia commonly
associated with intra-abdominal and pelvic abscesses and wounds. Enterococci are frequently found
in cultures from decubiti and foot ulcers, as well as in association with asteomyelitis in diabetics, but
their role in infections at these sites is not clearly defined.