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Enterococcus gallinarum

The genus Enterococus is mainly related to the “streptococci of fecal origin” or “enterococci”.

Taxonomy
Family: Enterococcaceae / Group D Streptococcus Lancefield

Natural habitats.
They are widespread in nature and can be found in soil, plants, water, food and animals.

In humans, they are predominantly inhabitants of the gastrointestinal tract and are less commonly found in other sites, such as in the genitourinary tract, the oral cavity, and skin.

Enterococci are considered the most abundant gram positive cocci colonizing the intestine, with E. faecalis being one of the most common bacteria isolated from this site.

Other species, such as E. faecium, E. casseliflavus, E. durans, and E. gallinarum, are also found in variable proportions in the gastrointestinal tract of humans.

Clinical significance
The enterococci are commensal microorganisms that act as opportunistic agents of infections, particularly in elderly patients with serious underlying diseases and other immunocompromised patients who have been hospitalized for prolonged periods, have been treated with invasive devices and / or have received broad-spectrum antimicrobial therapy.

Enterococci have become the second or third leading cause of nosocomial urinary tract infections (UTI’s), wound infections (mostly surgical, decubitus ulcers, and burn wounds), and bacteremia.

Enterococcus gallinarum and Enterococcus casseliflavus/flavescens are enterococci intrinsically resistant to vancomycin belonging to the E. gallinarum group. They are responsible mainly for healthcare-associated infections, in particular bloodstream, urinary tract and surgical wound infections.

Enterococcus casseliflavus

The genus Enterococus is mainly related to the “streptococci of fecal origin” or “enterococci”.

Taxonomy
Family: Enterococcaceae / Group D Streptococcus Lancefield

Natural habitats.
They are widespread in nature and can be found in soil, plants, water, food and animals.

In humans, they are predominantly inhabitants of the gastrointestinal tract and are less commonly found in other sites, such as in the genitourinary tract, the oral cavity, and skin.

Enterococci are considered the most abundant gram positive cocci colonizing the intestine, with E. faecalis being one of the most common bacteria isolated from this site.

Other species, such as E. faecium, E. casseliflavus, E. durans, and E. gallinarum, are also found in variable proportions in the gastrointestinal tract of humans.

Clinical significance
The enterococci are commensal microorganisms that act as opportunistic agents of infections, particularly in elderly patients with serious underlying diseases and other immunocompromised patients who have been hospitalized for prolonged periods, have been treated with invasive devices and / or have received broad-spectrum antimicrobial therapy.

Enterococci have become the second or third leading cause of nosocomial urinary tract infections (UTI’s), wound infections (mostly surgical, decubitus ulcers, and burn wounds), and bacteremia.

Enterococcus gallinarum and Enterococcus casseliflavus/flavescens are enterococci intrinsically resistant to vancomycin belonging to the E. gallinarum group. They are responsible mainly for healthcare-associated infections, in particular bloodstream, urinary tract and surgical wound infections.

Staphylococcus aureus

Taxonomy
Family: Staphylococcaceae

Natural habitats
Is found in the human respiratory tract and on the skin.

Clinical significance
S. aureus is responsible for many infections but it may also occur as a commensal.
The presence of S. aureus does not always indicate an infection.
They can survive from hours to weeks, or even months, on dry environmental surfaces.

Some types of S. aureus infectons
- impetigo, a small area of erythema that progresses into bullae (filled with pus), that rupture and heal with the formation of a honey colored crust of the skin
- folliculitis, a tender pustule that involves the hair follicle
- cellulitis, an infect of the skin layers
- furuncles and carbuncles (a collection of furuncles), small abscess
- mastitis, breastfeeding women, staphylococcal infection of the breast
- pneumonia, infection of the lungs
- osteomyelitis, staphylococci gets into the bones
- toxic shock syndrome (TSS) is most common in young women, who use highly absorbent vaginal tampon.
TSS has also been described in men and not menstruating women.
The causative agent is a toxin that is called toxic-shock syndrome toxin (TSST).
- sepsis, staphylococcal infection in the blood
- endocarditis, infection of the heart or heart valves
If the S. aureus infection gets into the bloodstream it can spread to other organs and cause severe and life-threatening infections (bacteremia or sepsis).

Sepsis can lead to shock or multi organ failure, which can rapidly lead to death.

SCVs of S. aureus
They are most commonly isolated from patient populations with usually persistent infections such as cystic fibrosis or chronic osteomyelitis and/or from patients who have prolonged exposure to aminoglycosides and cotrimoxazole.

Food poisoning
People get staphylococcal food poisoning by eating foods contaminated with S. aureus.
The bacterium releases a toxin into the foods, causing a rapid onset of severe nausea and vomiting. It may also cause fever.

Approximately 10 -15% of the healthy population are asymptomatic carriers among hospital staff, this percentage is higher.

The carrier can transmit the Staphylococcus or MRSA to other people.

Methicillin resistant Staphylococcus aureus / MRSA

MRSA infection is caused by a strain of S. aureus that's become resistant to the antibiotics commonly used to treat ordinary staphylococcal infections

MRSA strains are often hetero resistant to beta-lactam antibiotics in that two subpopulations (one susceptible and the other resistant) coexist within the culture.

Each cell in the population may carry the genetic information for resistance, but only a small fraction express the resistant phenotype under in vitro test conditions.

The resistant subpopulation usually grows much more slowly than the susceptible subpopulation and may be mist during laboratory testing

The successful detection of the hetero resistant strains depends largely on promoting the growth of the resistant subpopulation.

Cefoxitin disk (30 µg) diffusion is a better indicator of the presence of mecA-mediated resistance. Than the oxacillin disk.

aerobic Gram positive cocci