Enterococcal Infections

ByLarry M. Bush, MD, FACP, Charles E. Schmidt College of Medicine, Florida Atlantic University;
Maria T. Vazquez-Pertejo, MD, FACP, Wellington Regional Medical Center
Reviewed/Revised May 2023
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Enterococci are gram-positive, facultative anaerobic organisms. Enterococcus faecalis and E. faecium cause a variety of infections, including endocarditis, urinary tract infections, prostatitis, intra-abdominal infection, cellulitis, and wound infection as well as concurrent bacteremia.

Enterococci are part of the normal intestinal flora. They used to be classified as group D streptococci but are now considered a separate genus. There are > 47 species, but E. faecalis and E. faecium most commonly cause infections in humans.

Enterococci typically cause

Treatment of Enterococcal Infections

  • Varies by site of infection and susceptibility testing

(See also the American Heart Association's 2015 Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications.)

E. faecium are more resistant to penicillin than E. faecalisE. faecalisE. faecalis.

For complicated skin infections due to vancomycin

Resistance

In the past several decades, resistance to multiple antimicrobials has increased rapidly, especially among E. faecium.

E. faecium, continues to emerge.

Vancomycin-resistant enterococci (VRE) may also be resistant to other glycopeptides (eg, teicoplanin), aminoglycosides, and cell wall–active beta-lactamsstreptogramins (quinupristin/dalfopristin for E. faecium only) and oxazolidinonesvancomycin-resistant enterococcal urinary tract infection.

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  1. American Heart Association: Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications (2015)

Drugs Mentioned In This Article
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