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HelixTalk Episode #126 - Alex, I’ll Take Enterococcal Resistance Patterns and Treatments for $1000
Date posted: February 16, 2021, 6:00 am
In this episode, we chat with Morgan Anderson, PharmD, BCIDP and alumna of RFUMS, about Enterococcal infections including patterns of antimicrobial resistance and recommended treatment options.
- Enterococcus is a gram positive pathogen that is well known for intrinsic resistance to multiple antibiotic classes. It causes infections both in the community and hospital setting.
- Compared to E. faecalis, E. faecium is becoming more prevalent (especially in the hospital setting) and is much more likely to be resistant to ampicillin and vancomycin (VRE).
- Enterococcal resistance to ampicillin is due to overproduction of penicillin binding proteins with low B-lactam affinity. Resistance to vancomycin is due to changing the cross-link amino acid sequence from D-ala-D-ala to D-ala-D-lac.
- For serious vancomycin-resistant Enterococcal infections, the three main therapies include daptomycin, linezolid, and tigecycline.
- García-Solache M, Rice LB. The Enterococcus: a Model of Adaptability to Its Environment. Clin Microbiol Rev. 2019;32(2):e00058-18. Published 2019 Jan 30. doi:10.1128/CMR.00058-18
- Yim J, Smith JR, Rybak MJ. Role of Combination Antimicrobial Therapy for Vancomycin-Resistant Enterococcus faecium Infections: Review of the Current Evidence. Pharmacotherapy. 2017;37(5):579-592. doi:10.1002/phar.1922