Current Infectious Disease Reports

, Volume 14, Issue 4, pp 339–349

Enterococcal Endocarditis: Can We Win the War?

Cardiovascular Infections (DP Levine, Section Editor)

DOI: 10.1007/s11908-012-0270-8

Cite this article as:
Munita, J.M., Arias, C.A. & Murray, B.E. Curr Infect Dis Rep (2012) 14: 339. doi:10.1007/s11908-012-0270-8

Abstract

Treatment of enterococcal infections has long been recognized as an important clinical challenge, particularly in the setting of infective endocarditis (IE). Furthermore, the increase prevalence of isolates exhibiting multidrug resistance (MDR) to traditional anti-enterococcal antibiotics such as ampicillin, vancomycin and aminoglycosides (high-level resistance) poses immense therapeutic dilemmas in hospitals around the world. Unlike IE caused by most isolates of Enterococcus faecalis, which still retain susceptibility to ampicillin and vancomycin, the emergence and dissemination of a hospital-associated genetic clade of multidrug resistant Enterococcus faecium, markedly limits the therapeutic options. The best treatment of IE MDR enterococcal endocarditis is unknown and the paucity of antibiotics with bactericidal activity against these organisms is a cause of serious concern. Although it appears that we are winning the war against E. faecalis, the battle rages on against isolates of multidrug-resistant E. faecium.

Keywords

Infective endocarditis Enterococcus Therapy Multi-drug resistant enterococci Vancomycin resistance 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Infectious DiseasesCenter for the Study of Emerging and Reemerging PathogensHoustonUSA
  2. 2.Laboratory for Antimicrobial ResearchUniversity of Texas Medical School at HoustonHoustonUSA
  3. 3.Laboratory of Enterococcal ResearchUniversity of Texas Medical School at HoustonHoustonUSA
  4. 4.Department of Microbiology and Molecular GeneticsUniversity of Texas Medical School at HoustonHoustonUSA
  5. 5.Molecular Genetics and Antimicrobial Resistance UnitUniversidad El BosqueBogotáColombia
  6. 6.Clínica Alemana – Universidad del Desarrollo School of MedicineSantiagoChile
  7. 7.University of Texas Medical SchoolHoustonUSA

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