Ike Yasuyoshi
Professor Emeritus, Gunma University Graduate School of Medicine.
Representative Director, Association for Education in Bacterial Drug Resistance.
Nihon Saikingaku Zasshi. 2017;72(2):189-211. doi: 10.3412/jsb.72.189.
Enterococci belong to the group of lactic acid bacteria (LAB), and inhabit the gastrointestinal tracts of a wide variety of animals from insects and to human, and the commensal organism in humans and animals. The commensal/probiotic role of enterococci has evolved through thousands of years in mutual coexistence. Enterococcus have many favorable traits that have been appreciated in food fermentation and preservation, and many serve as probiotics to promote health. While lactobacillus have been shown to confer numerous benefits on and often regarded as health bringing organisms, enterococci have become more recognized as emerging human pathogens in recent years. Mac Callum and Hastings characterized an organism, now known to be Enterococcal faecalis, which was isolated from a lethal case of endocarditis on 1899. The report was the first detailed description of its pathogenic capabilities. Over the past few decades, multi-drug resistance enterococci have become as important health-care associated pathogen, and leading causes of drug resistance infection. The modern life style including the broad use of antibiotics in medical practice and animal husbandry have selected for the convergence of potential virulence factors to the specific enterococcus species such as E. faecium and E. faecalis. The development of modern medical care of intensive and invasive medical therapies and treatments for human disease, and existence of severe compromised patients in hospitals has contributed to the increased prevalence of these opportunistic organisms. The virulence factors converged in E. faecalis and E. faecium which have been isolated in nosocomial infections, include antibiotic resistance, extracellular proteins (toxins), extrachromosome and mobile genetic elements, cell wall components, biofilm formation, adherence factors, and colonization factor such as bacteriocin, etc. In these potential virulence factors, I presented characteristics of enterococcal conjugative plasmid, cytolysin, collagen binding protein of adhesion, bacteriocins, and drug resistances. I made reference to our original reports, and review books for this review. The review books are "Enterococci: from Commensals to Leading Causes of Drug Resistant Infection, NCBI Bookshelf. A service of the National Library of Medicine, National Institute of Health. Ed. by Michael S Gilmore, Don B Clewell, Yasuyoshi Ike, and Nathan Shankar", and "The Enterococci: Pathogenesis, Molecular Biology, and Antibiotic Resistance, Gilmore M., Clewell D., Courvadin P., Dunny G., Murray B., Rice L., (ed) 2002. ASM Press".
肠球菌属于乳酸菌（LAB）类群，栖息于从昆虫到人类等多种动物的胃肠道，是人和动物体内的共生生物。肠球菌的共生/益生菌作用在数千年的共存中不断演变。肠球菌具有许多在食品发酵和保存中受到重视的优良特性，许多肠球菌还可作为益生菌促进健康。虽然乳酸菌已被证明能带来诸多益处，常被视为有益健康的微生物，但近年来肠球菌却越来越被认为是新兴的人类病原体。1899年，Mac Callum和Hastings描述了一种后来被确认为粪肠球菌的微生物，该菌从一例致命的心内膜炎病例中分离得到。该报告首次详细描述了其致病能力。在过去几十年里，耐多药肠球菌已成为重要的医疗保健相关病原体，是耐药性感染的主要原因。现代生活方式，包括在医疗实践和畜牧业中广泛使用抗生素，促使潜在毒力因子在诸如屎肠球菌和粪肠球菌等特定肠球菌物种中汇聚。现代医疗中强化和侵入性的医疗疗法以及对人类疾病的治疗，以及医院中存在严重免疫功能低下的患者，都导致了这些机会性微生物的患病率上升。在医院感染中分离出的屎肠球菌和粪肠球菌中汇聚的毒力因子包括抗生素耐药性、细胞外蛋白（毒素）、染色体外和可移动遗传元件、细胞壁成分、生物膜形成、黏附因子以及诸如细菌素等定植因子。在这些潜在的毒力因子中，我阐述了肠球菌接合质粒、溶细胞素、黏附性胶原结合蛋白、细菌素和耐药性的特征。本综述参考了我们的原始报告以及相关书籍。这些书籍包括《肠球菌：从共生菌到耐药感染的主要病因，NCBI书架。美国国立医学图书馆、美国国立卫生研究院服务。由Michael S Gilmore、Don B Clewell、Yasuyoshi Ike和Nathan Shankar编辑》以及《肠球菌：发病机制、分子生物学与抗生素耐药性，Gilmore M.、Clewell D.、Courvadin P.、Dunny G.、Murray B.、Rice L.（编辑），2002年。ASM出版社》。
