tom 40 numer 3 rok 2001

POST. MIKROBIOL.
2001, 40, 3, 257—278
http://www.pm.microbiology.pl
ENTEROKOKI
PATOGENY XXI WIEKU
Jolanta Wieczyńska, Wanda Kamińska,
Danuta Dzierżanowska
1. Wstęp. 2. Epidemiologia. 3. Mechanizmy oporności. 3.1. Oporność na β-laktamy.
3.2. Oporność na aminoglikozydy. 3.3. Oporność na wankomycynę. 4. Klasyfikacja genotypowa
i mechanizmy działania antybiotyków. 5. Nowe antybiotyki. 6. Czynniki wirulencji. 7. Czynniki
ryzyka. 8. Chorobotwórczość. 9. Podsumowanie
Enterococci — pathogens of XXI Century
Abstract:
Enterococci are natural components of human and animal intestinal microflora.
Prior to identification of multiple-antibiotic-resistant strains in the late 1970s, enterococci were
considered relatiyely innocuous organisms. Over the past two decades, enterococci have been
identified as the agents of nosocomial infections with increasing frequency, since they acquired
resistance to most currently ayailable agents. As a result, enterococci have emerged as one of the
leading clinical challenges for physicians when identified as the cause of serious life-threating
infections. Since their initial recovery in 1988 in England and France, vancomycin-resistant
enterococci (vRE) were been found in many other countries. In Poland, they caused epidemical
infections in Haematology Clinic in Gdańsk in 1997—99. In Europe, primary source of VRE
was animal farms, where the use of avoparcin as a growth promoter in animal food seemed to be
the major contributor to vancomycinresistance. In the USA, VRE reservoirs include hospital staff
and patients; and organisms are transmitted by vectors such as medical equipment and health
care workers’ hands. Due to ease with which enterococci acquire and transfer antibiotic
resistance genes, they are particularly dangerous. Most frequently, enterococci are responsible
for nosocomial urinary tract infections, bacteraemias, and bacterial endocarditis. Apart from
subacute endocarditis, which typically occurs in older male patients with genitourinary tract
infection, most other enterococcal disease occur in patients with underlying conditions
representing a wide spectrum of diseases and immune disfuncion. Potential virulence factors,
which facilitate enterococcal colonization and infection, are investigated recently; the role of
some factors is disscused.
1. Introduction. 2. Epidemiology. 3. Mechanisms of resistance. 3.1. β-lactams resistance.
3.2. Aminoglicosides resistance. 3.3. vancomycin-resistance. 4. Genotypic clasification. 5. New
anti-enterococcal agents. 6. Virulence factors. 7. Risk factors. 8. Pathogenecity. 9. Summary
Zakład Mikrobiologii Klinicznej
Instytut pomnik Centrum Zdrowia Dziecka
Aleja Dzieci polskich 20, 04-736 Warszawa
Tel./fax (22) 815-42-30, 815-72-72