[Enterococci With Special Resistance Patterns - Epidemiology, Hygiene and Therapy]

Dtsch Med Wochenschr. 2019 Apr;144(8):553-560. doi: 10.1055/a-0655-6454. Epub 2019 Apr 15.
[Article in German]

Abstract

Enterococci with special resistance patterns (mainly vancomycin-resistant enterococci) play an important role in everyday clinical practice. Rising resistance rates to linezolid, daptomycin or tigecycline are also increasingly reported. Therapeutically, linezolid and daptomycin are the most important substances mainly in infections due to vancomycin-resistant enterococci. Several systematic meta-analyses of bloodstream infections showed discrepant results in the comparison of mortality of linezolid and daptomycin-treated bacteraemias. The containment of enterococci with special resistance patterns is currently receiving great attention. The key hygienic issue in all recommendations for dealing with multidrug-resistant enterococci can be summarized very simply: current scientific evidence is often inconsistent and studies that have clearly tested a single intervention for efficacy are lacking. The present work gives an insight into the current epidemiology and therapeutic strategies. Furthermore, the recently published German KRINKO recommendations are presented.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Daptomycin / pharmacology
  • Daptomycin / therapeutic use
  • Drug Resistance, Bacterial
  • Enterococcus / drug effects*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / prevention & control
  • Humans
  • Linezolid / pharmacology
  • Linezolid / therapeutic use
  • Lipoglycopeptides / pharmacology
  • Lipoglycopeptides / therapeutic use
  • Oxazolidinones / pharmacology
  • Oxazolidinones / therapeutic use
  • Tetrazoles / pharmacology
  • Tetrazoles / therapeutic use
  • Tigecycline / pharmacology
  • Tigecycline / therapeutic use
  • Vancomycin Resistance

Substances

  • Anti-Bacterial Agents
  • Lipoglycopeptides
  • Oxazolidinones
  • Tetrazoles
  • Tigecycline
  • tedizolid
  • Linezolid
  • Daptomycin