Enterococcal superinfection in patients treated with ciprofloxacin

Zervos, Marcus J.; Bacon, Alfred E.; Patterson, Jan E.; Schaberg, Dennis R.; Kauffman, Carol A.

doi:10.1093/jac/21.1.113

Cited by 54 publications

(25 citation statements)

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“…After about 3 weeks of these various therapies, E. faecalis was found in abdominal abscesses along with P. aeruginosa, Candida spp., and Proteus vulgaris. After 5 more days of ciprofloxacin and tobramycin, the patient became bacteremic with E. faecalis (231). These patients likely represent persistence of E. faecalis following fecal spillage and illustrate the important role enterococci can play in this type of patient, even when anti-enterococcal therapy has been used.…”

Section: Endocarditismentioning

confidence: 94%

“…In one study of 144 bacteremias in obstetrical and gynecological patients, 18 (13%) were due to enterococci, placing it second in frequency behind Escherichia coli; although the sources were not identified, it is clear that the majority were not from a urinary source (122). Enterococcal abscesses and bacteremia also occur with intraabdominal and biliary infections (53,80,129,193,231 (137). This infection occurred in 38 (6.6%) of 572 patients who had a UTI; of note, 28 of these 38 had urinary catheters, which is also considered a compounding factor in the development of enterococcal UTIs.…”

Section: Endocarditismentioning

confidence: 99%

“…Ticarcillin is only moderately active in vitro against enterococci and has little role in therapy of enterococcal infections. Ciprofloxacin and norfloxacin have been used successfully for enterococcal UTIs, but the organism's susceptibility is marginal for treating systemic infections with this drug and breakthrough has occurred at other sites of enterococcal infections (231). Nitrofurantoin may also be useful for UTIs.…”

Section: Management Of Enterococcal Infections Therapymentioning

confidence: 99%

See 2 more Smart Citations

The life and times of the Enterococcus

Murray¹

1990

Clin Microbiol Rev

1,717

1,221

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Enterococci are important human pathogens that are increasingly resistant to antimicrobial agents. These organisms were previously considered part of the genus Streptococcus but have recently been reclassified into their own genus, called Enterococcus. To date, 12 species pathogenic for humans have been described, including the most common human isolates, Enterococcus faecalis and E. faecium. Enterococci cause between 5 and 15% of cases of endocarditis, which is best treated by the combination of a cell wall-active agent (such as penicillin or vancomycin, neither of which alone is usually bactericidal) and an aminoglycoside to which the organism is not highly resistant; this characteristically results in a synergistic bactericidal effect. High-level resistance (MIC, greater than or equal to 2,000 micrograms/ml) to the aminoglycoside eliminates the expected bactericidal effect, and such resistance has now been described for all aminoglycosides. Enterococci can also cause urinary tract infections; intraabdominal, pelvic, and wound infections; superinfections (particularly in patients receiving expanded-spectrum cephalosporins); and bacteremias (often together with other organisms). They are now the third most common organism seen in nosocomial infections. For most of these infections, single-drug therapy, most often with penicillin, ampicillin, or vancomycin, is adequate. Enterococci have a large number of both inherent and acquired resistance traits, including resistance to cephalosporins, clindamycin, tetracycline, and penicillinase-resistant penicillins such as oxacillin, among others. The most recent resistance traits reported are penicillinase resistance (apparently acquired from staphylococci) and vancomycin resistance, both of which can be transferred to other enterococci. It appears likely that we will soon be faced with increasing numbers of enterococci for which there is no adequate therapy.

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Section: Endocarditismentioning

confidence: 94%

Section: Endocarditismentioning

confidence: 99%

Section: Management Of Enterococcal Infections Therapymentioning

confidence: 99%

See 1 more Smart Citation

The life and times of the Enterococcus

Murray¹

1990

Clin Microbiol Rev

1,717

1,221

View full text Add to dashboard Cite

show abstract

“…Despite such evidence several reviews on bacteremia have revealed that the source of enterococcal bacteremia is intra-abdominal infection in a significant number of cases (1,3,80). There are also several clinical reports of enterococci occurring as sole isolates in intra-abdominal infections (79,96,97). The presence of foreign bodies, such as dialysis catheters, and the use of prior antibiotics appear to be predisposing factors for enterococcal intra-abdominal infections (96,98).…”

Section: Epidemiologic Aspects Of Enterococcal Infectionmentioning

confidence: 99%

“…There are also several clinical reports of enterococci occurring as sole isolates in intra-abdominal infections (79,96,97). The presence of foreign bodies, such as dialysis catheters, and the use of prior antibiotics appear to be predisposing factors for enterococcal intra-abdominal infections (96,98).…”

Section: Epidemiologic Aspects Of Enterococcal Infectionmentioning

confidence: 99%