Enterococcus research: recent developments and clinical challenges

摘要

Over the last two decades, awareness of enterococci as important multidrug-resistant (MDR) nosocomial pathogens has increased [1,2]. Enterococci are now among the leading healthcare-associated pathogens worldwide [3-7]. Enterococcus faecalis and Enterococcus faecium remain the dominant species in clinical infections, although their relative contributions have changed over the years. The ratio of E faecalis to ? faecium in systemic infections has now approached 1:1 in many countries [3-5]. Importantly, the absolute and relative increase in ?faecium infections has been associated with acquired resistance to important anti-enterococcal agents such as ampicillin, aminoglycosides and vancomycin [3,8]. Molecular epidemiological studies and population structure analyses suggest that the emergence of E faecalis and E faecium as major nosocomial pathogens has resulted from the evolutionary development of specific hospital-associated lineages or clonal complexes in which antimicrobial resistance and virulence determinants have accumulated [9-11].