Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Antimicrob Resist Infect Control. 2020 Aug 10;9(1):130. doi: 10.1186/s13756-020-00770-1.
Early in its evolution, Enterococcus faecium acquired traits that allowed it to become a successful nosocomial pathogen. E. faecium inherent tenacity to build resistance to antibiotics and environmental stressors that allows the species to thrive in hospital environments. The continual wide use of antibiotics in medicine has been an important driver in the evolution of E. faecium becoming a highly proficient hospital pathogen.For successful prevention and reduction of nosocomial infections with vancomycin resistant E. faecium (VREfm), it is essential to focus on reducing VREfm carriage and spread. The aim of this review is to incorporate microbiological insights of E. faecium into practical infection control recommendations, to reduce the spread of hospital-acquired VREfm (carriage and infections). The spread of VREfm can be controlled by intensified cleaning procedures, antibiotic stewardship, rapid screening of VREfm carriage focused on high-risk populations, and identification of transmission routes through accurate detection and typing methods in outbreak situations. Further, for successful management of E. faecium, continual innovation in the fields of diagnostics, treatment, and eradication is necessary.
粪肠球菌在其进化早期获得了一些特性，使其成为一种成功的医院病原体。粪肠球菌固有的耐药性和对环境压力的适应能力，使其能够在医院环境中茁壮成长。抗生素在医学上的广泛持续使用是粪肠球菌进化成为一种高度有效的医院病原体的重要驱动因素。为了成功预防和减少耐万古霉素粪肠球菌（VREfm）引起的医院感染，必须重点减少 VREfm 的携带和传播。本综述的目的是将粪肠球菌的微生物学见解纳入实用的感染控制建议中，以减少医院获得性 VREfm（携带和感染）的传播。通过强化清洁程序、抗生素管理、针对高危人群的 VREfm 携带快速筛查以及在暴发情况下通过准确检测和分型方法确定传播途径，可以控制 VREfm 的传播。此外，为了成功管理粪肠球菌，需要在诊断、治疗和根除领域不断创新。
