Enterococcus
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2008-06-19T11:59:16Z
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{{Taxobox
| color = lightgrey
| name = ''Enterococcus''
| image = Enterococcus_histological_pneumonia_01.png
| image_width = 240px
| image_caption = ''Enterococcus sp.'' infection in [[pulmonary]] tissue.
| regnum = [[Bacterium|Bacteria]]
| divisio = [[Firmicutes]]
| classis = [[Bacilli]]
| ordo = [[Lactobacillales]]
| familia = [[Enterococcaceae]]
| genus = '''''Enterococcus'''''
| genus_authority = (''ex'' Thiercelin & Jouhaud 1903)<br>Schleifer & Kilpper-Bälz 1984
| subdivision_ranks = Species
| subdivision =
''[[Enterococcus avium|E. avium]]''<br/>
''[[Enterococcus durans|E. durans]]''<br/>
''[[Enterococcus faecalis|E. faecalis]]''<br/>
''[[Enterococcus faecium|E. faecium]]''<br/>
''[[Enterococcus solitarius|E. solitarius]]''<br/>
etc.
}}
'''''Enterococcus''''' is a [[genus]] of [[lactic acid bacteria]] of the [[Phylum (biology)|phylum]] [[Firmicutes]]. Members of this genus were classified as ''Group D [[Streptococcus]]'' until 1984 when genomic DNA analysis indicated that a separate genus classification was appropriate.<ref>{{cite journal | author = Schleifer KH; Kilpper-Balz R | title = Transfer of ''Streptococcus faecalis'' and ''Streptococcus faecium'' to the genus ''Enterococcus'' nom. rev. as ''Enterococcus faecalis'' comb. nov. and ''Enterococcus faecium'' comb. nov. | journal= Int. J. Sys. Bacteriol. | year= 1984 | volume= 34 | issue= | pages= 31–34 | url= }}</ref>
Enterococci are [[Gram-positive]] [[cocci]] which often occur in pairs ([[diplococcus|diplococci]]) and are difficult to distinguish from ''[[Streptococcus|Streptococci]]'' on physical characteristics alone. Two species are common [[commensal]] organisms in the intestines of humans: ''[[Enterococcus faecalis|E. faecalis]]'' (90-95%) and ''[[Enterococcus faecium|E. faecium]]'' (5-10%). Enterococci are [[facultative anaerobic organism]]s, i.e. they prefer the use of [[oxygen]], but they can survive in the absence of oxygen.<ref name=Fischetti_2000>{{cite book | author = Fischetti VA; Novick RP; Ferretti JJ; Portnoy DA; Rood JI (editors) | title = Gram-Positive Pathogens | publisher = ASM Press | year = 2000 | id = ISBN 1-55581-166-3}}</ref> They typically exhibit gamma-[[hemolysis]] on sheep's blood agar.
==Pathology==
Important clinical infections caused by ''Enterococcus'' include [[urinary tract infection]]s, [[bacteremia]], [[bacterial endocarditis]], [[diverticulitis]], and [[meningitis]].<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = 294–5 |publisher = McGraw Hill | year = 2004 | isbn = 0-8385-8529-9 }}</ref> Sensitive strains of these bacteria can be treated with [[ampicillin]] and [[vancomycin]].<ref name=Baron>{{cite book | author = Pelletier LL Jr. | title = Microbiology of the Circulatory System. ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.5077 | isbn = 0-9631172-1-1 }}</ref>
From a medical standpoint, the most important feature of this genus is their high level of endemic [[antibiotic resistance]]. Some Enterococci are [[Wiktionary:intrinsic|intrinsically]] resistant to β-lactam-based antibiotics (some [[penicillin]]s and virtually all [[cephalosporin]]s) as well as many [[aminoglycoside]]s.<ref name=Sherris /> In the last two decades, particularly virulent strains of ''Enterococcus'' which are resistant to vancomycin ([[Vancomycin-resistant enterococcus]], or VRE) have emerged in [[nosocomial]] infections of hospitalized patients especially 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 (Synercid) with response rates of approximately 70%.<ref name=Tünger_2004>{{cite journal |author=Tünger A, Aydemir S, Uluer S, Cilli F |title=In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci |journal=Indian J Med Res |volume=120 |issue=6 |pages=546–52 |year=2004 |pmid=15654141}}</ref>
Enterococcal meningitis is a rare complication of neurosurgery. It often requires treatment with intravenous [[vancomycin]]; [[intrathecal]] vancomycin is often used and it is debatable whether this has any impact on outcome. The removal of any neurological devices is a crucial part of the management of these infections.<ref name=Guardado_2006>{{cite journal |author=Guardado R, Asensi V, Torres JM, ''et al'' |title=Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases |journal=Scand. J. Infect. Dis. |volume=38 |issue=8 |pages=584–8 |year=2006 |pmid=16857599 |doi=10.1080/00365540600606416}}</ref>
==Water quality==
In bodies of water, the acceptable level of contamination is very 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, above which the state may post warnings to stay out of the ocean.<ref name=Hawaii_DOH>{{cite web | title=Clean Water Branch | work=Hawaii State Department of Health | url=http://www.hawaii.gov/health/environmental/water/cleanwater/index.html | accessdate=2007-02-08}}</ref> In 2004, ''Enterococcus spp.'' took the place of [[fecal coliform]] as the new federal standard for water quality at public beaches. It is believed to provide a higher correlation than fecal coliform with many of the human pathogens often found in sewage.<ref name=Jin_2004>{{cite journal |author=Jin G, Jeng HW, Bradford H, Englande AJ |title=Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment |journal=Water Environ. Res. |volume=76 |issue=3 |pages=245–55 |year=2004 |pmid=15338696|doi=10.2175/106143004X141807}}</ref>
==References==
{{reflist|2}}
[[Category:Lactobacillales]]
[[de:Enterokokken]]
[[es:Enterococcus]]
[[fr:Entérocoque]]
[[it:Enterococcus]]
[[ja:腸球菌]]
[[pl:Enterokoki]]
[[pt:Enterococcus]]
[[sr:Ентерококе]]
[[sv:Enterokocker]]