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Enterococcus faecalis – formerly classified as part of the group D Streptococcus system – is a Gram-positive, commensal bacterium inhabiting the gastrointestinal tracts of humans. [ 1 ] [ 2 ] Like other species in the genus Enterococcus , E. faecalis is found in healthy humans and can be used as a probiotic.
Some enterococci are intrinsically resistant to β-lactam-based antibiotics (penicillins, cephalosporins, carbapenems), as well as many aminoglycosides. [8] In the last two decades, particularly virulent strains of Enterococcus that are resistant to vancomycin ( vancomycin-resistant Enterococcus , or VRE) have emerged in nosocomial infections ...
Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum cephalosporin-resistant Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, or Klebsiella oxytoca. Some exclude ertapenem resistance from the definition.
This class of antibiotics is usually reserved for known or suspected multidrug-resistant (MDR) bacterial infections. Similar to penicillins and cephalosporins, carbapenems are members of the beta-lactam antibiotics drug class, which kill bacteria by binding to penicillin-binding proteins, thus inhibiting bacterial cell wall synthesis. However ...
Chromosomal-mediated AmpC β-lactamases represent a new threat, since they confer resistance to 7-alpha-methoxy-cephalosporins (cephamycins) such as cefoxitin or cefotetan but are not affected by commercially available β-lactamase inhibitors, and can, in strains with loss of outer membrane porins, provide resistance to carbapenems.
Ceftaroline has also been described as "fifth-generation" cephalosporin, but does not have the activity against Pseudomonas aeruginosa or vancomycin-resistant enterococci that ceftobiprole has. [36] Ceftolozane is an option for the treatment of complicated intra-abdominal infections and complicated urinary tract infections.
There are multiple national and international monitoring programs for drug-resistant threats, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA), extended spectrum beta-lactamase (ESBL) producing Enterobacterales, vancomycin-resistant Enterococcus (VRE), and multidrug-resistant Acinetobacter ...
Infections are generally sensitive to antibiotics designed for this bacteria class, though complicated by inducible resistance mechanisms, [5] particularly lactamase; infections accordingly become quickly resistant to standard antibiotics during treatment, necessitating a change in antibiotic to avoid worsening of the sepsis.