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Enterococcus
Enterococcus is a genus of bacteria which lives
in the human body, notably in the digestive and
urinary tracts. It is generally a benign
bacteria in people with normal health and
without compromised immune systems. It has the
characteristic of being very resistant to
antibiotics and treatment of the bacteria can be
problematic.
There are more than seventeen identified species
in the enterococci genus.(1) Only a very few are
known to be of significant interest from a
health and clinical treatment aspect.(2)
Vancomycin-Resistant Enterococcus (VRE) is a
particularly resistant strain, believed to have
originated in Europe and the UK and spread to
the US. In the UK, approximately 5% of the
population is believed to be carrying this
strain of Enterococcus, but do not have any
symptoms manifest unless they are in a high-risk
group. Groups at high risk are hospital
personnel – including doctors, nurses and other
medical staff – and hospitalized patients or
visitors. Very old, very young, or very ill
individuals are also susceptible. (3)
Exposure can be by contact with a contaminated
person or an object touched by a carrier. It can
be transmitted in food, by direct touch, or
indirect contact with a contaminated surface. In
the US, the only reported cases were all traced
back to initial contact in a hospital.
The best methods of controlling this strain are
meticulous personal hygiene – paying particular
attention to washing hands at frequent intervals
– avoiding hospitals and limiting use of
antibiotics for treatment of routine illness.
Control of existing Enterococcus colonies – even
VRE – is simple. Stay healthy and maintain a
well-balanced concentration of stomach flora.
Course of treatment involves a number of
pharmaceuticals, dependent on test results and
particular strain. Johns Hopkins has conducted
exhaustive studies of treatment and control of
the Enterococcus in the intestinal, urinary and
reproductive systems.(4)
There was an extensive cost-benefit study
conducted in 1999 that concluded the
Enterococcus could be controlled and effectively
diminished by use of disposable gown and glove
use. Cost of the care versus the cost of
treatment led to increases in initial
expenditures, however, the cost was more than
offset by the cost of treatment.(5)
Enterococcal infection poses a significant
mortality risk to older, male, ICU hospital
patients with a history of recent antibiotic use
and with a compromised immune system or wounds
from surgery or accident.(6)
There are probiotic uses of ingested
Enterococcus, and several studies on swine and
piglets have yielded positive results in
controlled experiments as published by the
American Society of Microbiology. Results
indicate a 20%-25% decrease in chlamydia
infection with a 100% correlation between four
independent testing methods.(7)
While testing in humans is limited due to the
relative youth of the genus (established in
1986), there are promising results from animal
testing. When considered with the relatively low
incidence of complications in healthy adults who
are not in contact with a high-risk group, this
bacteria could be of significant use in the
control of more dangerous and harmful infections
as chlamydia.
[NB to TextBroker editors. Please disable
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WILL set off alarms!]
(1)Identification of Enterococcus Species and
Phenotypically Similar Lactococcus and
Vagococcus Species by Reverse Checkerboard
Hybridization to Chaperonin 60 Gene Sequences by
Swan Hee Goh, PhD, et al; 1999; Scientic
Commons; http://en.scientificcommons.org/18965006
(2)eMedicine article by Susan L. Fraser, MD, et
al. Updated 8/2008. http://emedicine.medscape.com/article/216993-overview
(3)VRE by New York Department of Health;
November 2006; Vancomycin Resistant Enterococcus
Fact Sheet.
(4)Johns Hopkins ABX Guide by Lisa A. Spacek,
MD, PhD and Joseph Vinetz, MD; August 2009.
(5)A cost-benefit analysis of gown use in
controlling vancomycin-resistant Enterococcus
transmission: Is it worth the price? by Laura
Puzniak, et al; 2006.
(6)Enterococcal Infection by Meera Varman, MD,
et al; November 2009.
(7)Effects of a Probiotic Strain of Enterococcus
faecium on the Rate of Natural Chlamydia
Infection in Swine by Pollmann, et al; February
2005.
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