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Enterococcus is a large genus of lactic acid bacteria of the phylum Firmicutes. Enterococci are Gram-positive cocci that often occur in pairs (diplococci) or short chains, and are difficult to distinguish from streptococci on physical characteristics alone.^[2] Two species are common commensal organisms in the intestines of humans: E. faecalis (90-95%) and E. faecium (5-10%). Rare clusters of infections occur with other species, including E. casseliflavus, E. gallinarum, and E. raffinosus.^[2]

Physiology and classification

Enterococci are facultative anaerobic organisms, i.e., they are capable of cellular respiration in both oxygen-rich and oxygen-poor environments.^[3] Though they are not capable of forming spores, enterococci are tolerant of a wide range of environmental conditions: extreme temperature (10-45°C), pH (4.5-10.0) and high sodium chloride concentrations.^[4]

Enterococci typically exhibit gamma-hemolysis on sheep's blood agar.^[5]

History

Members of the genus Enterococcus (from Greek έντερο, éntero, "intestine" and κοκκος, coccos, "granule") were classified as Group D Streptococcus until 1984, when genomic DNA analysis indicated a separate genus classification would be appropriate.^[6]

Pathology

Important clinical infections caused by Enterococcus include urinary tract infections, bacteremia, bacterial endocarditis, diverticulitis, and meningitis.^[4]^[5] Sensitive strains of these bacteria can be treated with ampicillin, penicillin and vancomycin.^[7] Urinary tract infections can be treated specifically with nitrofurantoin, even in cases of vancomycin resistance.^[8]

From a medical standpoint, an important feature of this genus is the high level of intrinsic antibiotic resistance. Some enterococci are intrinsically resistant to β-lactam-based antibiotics (penicillins, cephalosporins, carbapenems), as well as many aminoglycosides.^[5] 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 of hospitalized patients, especially in the US.^[4] Other developed countries, such as the UK, have been spared this epidemic, and, in 2005, Singapore managed to halt an epidemic of VRE.^[9] VRE may be treated with quinupristin/dalfopristin (Synercid) with response rates of approximately 70%.^[10] Tigecycline has also been shown to have anti-enterococcal activity as has rifampicin.^{[citation needed]}

Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous or intrathecal vancomycin, yet it is debatable as to whether its use has any impact on outcome: the removal of any neurological devices is a crucial part of the management of these infections.^[11] New epidemiological evidence has shown that enterococci are major infectious agent in chronic bacterial prostatitis^{[citation needed]}. Enterococci are able to form biofilm in the prostate gland making their eradication difficult.

Water quality

In bodies of water, the acceptable level of contamination is very low; for example in the state of Hawaii, and most of the United States, the limit for water off its beaches is a five-week geometric mean of 35 colony-forming units per 100 ml of water, above which the state may post warnings to stay out of the ocean.^[12] In 2004, Enterococci sp. took the place of fecal coliforms as the new USA federal standard for water quality at public saltwater beaches and E. coli at freshwater beaches.^[13] It is believed to provide a higher correlation than fecal coliform with many of the human pathogens often found in city sewage.^[14]

References

^ LPSN entry for Enterococcus
^ ^a ^b Gilmore MS et al., eds. (2002). The Enterococci: Pathogenesis, Molecular Biology, and Antibiotic Resistance. Washington, D.C.: ASM Press. ISBN 978-1-55581-234-8.
^ Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JI, ed. (2000). Gram-Positive Pathogens. ASM Press. ISBN 1-55581-166-3.
^ ^a ^b ^c Fisher K, Phillips C (June 2009). "The ecology, epidemiology and virulence of Enterococcus". Microbiology 155 (Pt 6): 1749–57. doi:10.1099/mic.0.026385-0. PMID 19383684.
^ ^a ^b ^c Ryan KJ, Ray CG, ed. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 294–5. ISBN 0-8385-8529-9.
^ Schleifer KH; Kilpper-Balz R (1984). "Transfer of Streptococcus faecalis and Streptococcus faecium to the genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov.". Int. J. Sys. Bacteriol. 34: 31–34. doi:10.1099/00207713-34-1-31.
^ Pelletier LL Jr. (1996). Microbiology of the Circulatory System. in: Baron's Medical Microbiology (Baron S et al., eds.) (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
^ Zhanel GG, Hoban DJ, Karlowsky JA (January 2001). "Nitrofurantoin is active against vancomycin-resistant enterococci". Antimicrob. Agents Chemother. 45 (1): 324–6. doi:10.1128/AAC.45.1.324-326.2001. PMC 90284. PMID 11120989.
^ Kurup, Asok; Chlebicki, M.P.; Ling, M.L.; Koh, T.H.; Tan, K.Y.; Lee, L.C.; Howe, K.B.M. (April 2008). "Control of a hospital-wide vancomycin-resistant Enterococci outbreak". American Journal of Infection Control 36 (3): 206–211. doi:10.1016/j.ajic.2007.06.005. Retrieved 26 November 2014.
^ Tünger A, Aydemir S, Uluer S, Cilli F (2004). "In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci". Indian J Med Res 120 (6): 546–52. PMID 15654141.
^ Guardado R; Asensi V; Torres JM et al. (2006). "Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases". Scand. J. Infect. Dis. 38 (8): 584–8. doi:10.1080/00365540600606416. PMID 16857599.
^ "Clean Water Branch" (PDF). Hawaii State Department of Health. Retrieved 2012-05-18.
^ "Water Quality Standards for Coastal and Great Lakes Recreation Waters; Final Rule". Federal Register 69 (220): 67218–67243. 16 November 2004. Retrieved 26 November 2014.
^ Jin G, Jeng HW, Bradford H, Englande AJ (2004). "Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment". Water Environ. Res. 76 (3): 245–55. doi:10.2175/106143004X141807. PMID 15338696.

UpToDate Contents

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1. 腸球菌感染症の治療 treatment of enterococcal infections
2. 腸球菌の微生物学 microbiology of enterococci
3. バンコマイシン耐性腸球菌の疫学、予防および管理 epidemiology prevention and control of vancomycin resistant enterococci
4. 腸球菌における抗菌薬耐性の機構 mechanisms of antibiotic resistance in enterococci
5. 固有弁心内膜炎の抗菌療法 antimicrobial therapy of native valve endocarditis

English Journal

Lipid components and water soluble metabolites in salted and dried tuna (Thunnus thynnus L.) roes.

Scano P, Rosa A, Pisano MB, Piras C, Cosentino S, Dessi' MA.SourceDipartimento di Scienze Chimiche, Università di Cagliari, Cagliari, Italy. Electronic address: scano@unica.it.
Food chemistry.Food Chem.2013 Jun 15;138(4):2115-21. doi: 10.1016/j.foodchem.2012.11.095. Epub 2012 Dec 2.
The salted and dried product of tuna roe (bottarga) is a seafood characteristic of the Mediterranean area and exported all over the world. Samples of bottarga from bluefin tunas (Thunnus thynnus, L.) caught in the southwest Mediterranean sea were analysed. The samples were characterised by high cont
PMID 23497865

Virulence traits and antibiotic resistance among enterococci isolated from Eurasian otter (Lutra lutra).

Semedo-Lemsaddek T, Nóbrega CS, Ribeiro T, Pedroso NM, Sales-Luís T, Lemsaddek A, Tenreiro R, Tavares L, Vilela CL, Oliveira M.SourceCentro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade Técnica de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal. Electronic address: tlemsaddek@fmv.utl.pt.
Veterinary microbiology.Vet Microbiol.2013 May 3;163(3-4):378-82. doi: 10.1016/j.vetmic.2012.12.032. Epub 2013 Jan 17.
Enterococci are ubiquitous microorganisms found as part of the normal intestinal microbiota of many animals such as the free-ranging Eurasian otter (Lutra lutra Linnaeus, 1758). In this work, twenty-nine enterococci isolated from fecal samples of Eurasian otters free-living in reservoirs and associa
PMID 23375652

The global spread of healthcare-associated multidrug-resistant bacteria: a perspective from Asia.

Molton JS, Tambyah PA, Ang BS, Ling ML, Fisher DA.SourceDivision of Infectious Diseases, National University Health System.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.Clin Infect Dis.2013 May;56(9):1310-8. doi: 10.1093/cid/cit020. Epub 2013 Jan 18.
Since antibiotics were first used, each new introduced class has been followed by a global wave of emergent resistance, largely originating in Europe and North America where they were first used. Methicillin-resistant Staphylococcus aureus spread from the United Kingdom and North America across Euro
PMID 23334810

Japanese Journal

臨床研究腸球菌による白内障術後眼内炎の臨床像の検討

鈴木崇,戸所大輔,小早川信一郎 [他]
日本眼科学会雑誌 118(1), 22-27, 2014-01
NAID 40019948147

バンコマイシン耐性腸球菌 (特集外科領域における耐性菌)

高倉俊二
日本外科感染症学会雑誌 10(3), 293-298, 2013-06
NAID 40019764950

連鎖球菌・腸球菌 : PRSP・VREを中心に (特集いま,敗血症をどう治療するか : 早期見極めと迅速治療の指針) -- (耐性菌から考える敗血症治療指針)

髙倉俊二
感染と抗菌薬 16(1), 50-55, 2013-03
NAID 40019627292

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★リンクテーブル★

リンク元	「enterococcal」
拡張検索	「vancomycin-resistant enterococci」

「enterococcal」

Enterococcus
Classification and external resources
ICD-9	041.04

Enterococcus
	Enterococcus sp. infection in pulmonary tissue
Scientific classification
Kingdom:	Bacteria
Division:	Firmicutes
Class:	Bacilli
Order:	Lactobacillales
Family:	Enterococcaceae
Genus:	Enterococcus; (ex Thiercelin & Jouhaud 1903); Schleifer & Kilpper-Bälz 1984
Species
	Enterococcus alcedinis; Enterococcus aquimarinus; Enterococcus asini; Enterococcus avium; Enterococcus caccae; Enterococcus camelliae; Enterococcus canintestini; Enterococcus canis; Enterococcus casseliflavus; Enterococcus cecorum; Enterococcus columbae; Enterococcus devriesei; Enterococcus diestrammenae; Enterococcus dispar; Enterococcus durans; Enterococcus eurekensis; Enterococcus faecalis; Enterococcus faecium; Enterococcus gallinarum; Enterococcus gilvus; Enterococcus haemoperoxidus; Enterococcus hermanniensis; Enterococcus hirae; Enterococcus italicus; Enterococcus lactis; Enterococcus lemanii; Enterococcus malodoratus; Enterococcus moraviensis; Enterococcus mundtii; Enterococcus olivae; Enterococcus pallens; Enterococcus phoeniculicola; Enterococcus plantarum; Enterococcus pseudoavium; Enterococcus quebecensis; Enterococcus raffinosus; Enterococcus ratti; Enterococcus rivorum; Enterococcus rotai; Enterococcus saccharolyticus; Enterococcus silesiacus; Enterococcus solitarius; Enterococcus sulfureus; Enterococcus termitis; Enterococcus thailandicus; Enterococcus ureasiticus; Enterococcus ureilyticus; Enterococcus viikkiensis; Enterococcus villorum; Enterococcus xiangfangensis;

　　[★]

腸球菌の

関: enterococci、Enterococcus

「vancomycin-resistant enterococci」

　　[★] バンコマイシン耐性腸球菌 VRE

[1] LPSN entry for Enterococcus

[Gilmore_2002-2] Gilmore MS et al., eds. (2002). The Enterococci: Pathogenesis, Molecular Biology, and Antibiotic Resistance. Washington, D.C.: ASM Press. ISBN 978-1-55581-234-8.

[Fischetti_2000-3] Fischetti VA, Novick RP, Ferretti JJ, Portnoy DA, Rood JI, ed. (2000). Gram-Positive Pathogens. ASM Press. ISBN 1-55581-166-3.

[Fisher-4] Fisher K, Phillips C (June 2009). "The ecology, epidemiology and virulence of Enterococcus". Microbiology 155 (Pt 6): 1749–57. doi:10.1099/mic.0.026385-0. PMID 19383684.

[Sherris-5] Ryan KJ, Ray CG, ed. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 294–5. ISBN 0-8385-8529-9.

[6] Schleifer KH; Kilpper-Balz R (1984). "Transfer of Streptococcus faecalis and Streptococcus faecium to the genus Enterococcus nom. rev. as Enterococcus faecalis comb. nov. and Enterococcus faecium comb. nov.". Int. J. Sys. Bacteriol. 34: 31–34. doi:10.1099/00207713-34-1-31.

[Baron-7] Pelletier LL Jr. (1996). Microbiology of the Circulatory System. in: Baron's Medical Microbiology (Baron S et al., eds.) (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.

[pmid11120989-8] Zhanel GG, Hoban DJ, Karlowsky JA (January 2001). "Nitrofurantoin is active against vancomycin-resistant enterococci". Antimicrob. Agents Chemother. 45 (1): 324–6. doi:10.1128/AAC.45.1.324-326.2001. PMC 90284. PMID 11120989.

[9] Kurup, Asok; Chlebicki, M.P.; Ling, M.L.; Koh, T.H.; Tan, K.Y.; Lee, L.C.; Howe, K.B.M. (April 2008). "Control of a hospital-wide vancomycin-resistant Enterococci outbreak". American Journal of Infection Control 36 (3): 206–211. doi:10.1016/j.ajic.2007.06.005. Retrieved 26 November 2014.

[10] Tünger A, Aydemir S, Uluer S, Cilli F (2004). "In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci". Indian J Med Res 120 (6): 546–52. PMID 15654141.

[Guardado_2006-11] Guardado R; Asensi V; Torres JM et al. (2006). "Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases". Scand. J. Infect. Dis. 38 (8): 584–8. doi:10.1080/00365540600606416. PMID 16857599.

[Hawaii_DOH-12] "Clean Water Branch" (PDF). Hawaii State Department of Health. Retrieved 2012-05-18.

[13] "Water Quality Standards for Coastal and Great Lakes Recreation Waters; Final Rule". Federal Register 69 (220): 67218–67243. 16 November 2004. Retrieved 26 November 2014.

[Jin_2004-14] Jin G, Jeng HW, Bradford H, Englande AJ (2004). "Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment". Water Environ. Res. 76 (3): 245–55. doi:10.2175/106143004X141807. PMID 15338696.

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enterococci