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Enterococcus
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== Pathology == Important clinical infections caused by ''Enterococcus'' include [[urinary tract infection]]s (see ''[[Enterococcus faecalis]]''), [[bacteremia]], [[bacterial endocarditis]], [[diverticulitis]], [[meningitis]], and [[spontaneous bacterial peritonitis]].<ref name="Fisher" /><ref name="Sherris">{{cite book | veditors = Ryan KJ, Ray CG | title = Sherris Medical Microbiology | edition = 4th | pages = 294–5 |publisher = McGraw Hill | year = 2004 | isbn = 0-8385-8529-9 }}</ref><ref>{{cite journal | vauthors = Fiore M, Maraolo AE, Gentile I, Borgia G, Leone S, Sansone P, Passavanti MB, Aurilio C, Pace MC | title = Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis | journal = World Journal of Hepatology | volume = 9 | issue = 30 | pages = 1166–1175 | date = October 2017 | pmid = 29109849 | pmc = 5666303 | doi = 10.4254/wjh.v9.i30.1166 | doi-access = free }}</ref> Sensitive strains of these bacteria can be treated with [[ampicillin]], [[penicillin]] and [[vancomycin]].<ref name="Baron">{{cite book | vauthors = Pelletier Jr LL | chapter = Microbiology of the Circulatory System|title= Baron's Medical Microbiology | veditors = Albrecht T, Baron S | edition = 4th | publisher = Univ of Texas Medical Branch | year = 1996 | pmid = 21413321| url = https://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.5077 | isbn = 0-9631172-1-1 }}</ref> In catheterized patients receiving [[Intensive care unit|intensive care]], ''Enterococcus'' spp., have been reported the dominant cause of urinary tract infections, particularly in patients treated with [[cephalosporin]] antibiotics.<ref>{{Cite journal |last=Karlsson |first=Philip A. |last2=Bolin |first2=Christian |last3=Spång |first3=Labolina |last4=Frithiof |first4=Robert |last5=Hultström |first5=Michael |last6=Lipcsey |first6=Miklos |last7=Wang |first7=Helen |last8=Järhult |first8=Josef D. |date=2024-11-07 |title=Bacteriuria and antibiotic use during the third wave of COVID-19 intensive care in Sweden |url=https://www.tandfonline.com/doi/full/10.1080/23744235.2024.2423884 |journal=Infectious Diseases |language=en |pages=1–10 |doi=10.1080/23744235.2024.2423884 |issn=2374-4235|doi-access=free }}</ref> Urinary tract infections can be treated specifically with [[nitrofurantoin]], even in cases of vancomycin resistance.<ref name="pmid11120989">{{cite journal | vauthors = Zhanel GG, Hoban DJ, Karlowsky JA | title = Nitrofurantoin is active against vancomycin-resistant enterococci | journal = Antimicrobial Agents and Chemotherapy | volume = 45 | issue = 1 | pages = 324–326 | date = January 2001 | pmid = 11120989 | pmc = 90284 | doi = 10.1128/AAC.45.1.324-326.2001 }}</ref> [[File:Diagnostic algorithm of possible bacterial infection.png|thumb|left|Example of a workup algorithm of possible bacterial infection in cases with no specifically requested targets (non-bacteria, mycobacteria etc.), with most common situations and agents seen in a New England community hospital setting. ''Enterococcus'' is included near bottom-center.]] === Meningitis === {{Main|Meningitis}} 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.<ref name="Guardado_2006">{{cite journal | vauthors = Guardado R, Asensi V, Torres JM, Pérez F, Blanco A, Maradona JA, Cartón JA | title = Post-surgical enterococcal meningitis: clinical and epidemiological study of 20 cases | journal = Scandinavian Journal of Infectious Diseases | volume = 38 | issue = 8 | pages = 584–588 | year = 2006 | pmid = 16857599 | doi = 10.1080/00365540600606416 | s2cid = 24189202 }}</ref> New epidemiological evidence has shown that enterococci are major infectious agent in chronic bacterial [[prostatitis]].<ref>{{cite web | title = Enterococcus sp rRNA [Presence] in Specimen by Probe | url = https://loinc.org/5001-3 | id = 5001-3 | work = Logical Observation Identifiers Names and Codes (LOINC) | publisher = Regenstrief Institute, Inc. }}</ref> Enterococci are able to form [[biofilm]] in the prostate gland, making their eradication difficult.{{citation needed|date=February 2023}} Cases of enterococcal meningitis, in the absence of trauma or surgery, should raise suspicion of an underlying intestinal pathology (e.g., strongyloidiasis).<ref>{{cite journal | vauthors = Cosimi L, Di Bella S, Luzzati R, Simeth CT, Pinamonti M, Cominotto F, Sisto UG | title = Enterococcal meningitis associated with ''Strongyloides'' infection: a case report and literature review | journal = Le Infezioni in Medicina | volume = 31 | issue = 4 | pages = 583–590 | date = 2023-12-01 | pmid = 38075422 | pmc = 10705849 | doi = 10.53854/liim-3104-18 }}</ref>
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