title: Treatment and prevention of enterococcal infections--alternative and experimental approaches.
abstract: Enterococci are one of the leading types of organisms isolated from infections of hospitalised patients and the third most common cause of nosocomial bloodstream infections. They contribute significantly to patient mortality and morbidity, as well as healthcare costs. The emergence of resistance against virtually all clinically available antibiotics and the ability to transfer these resistance determinants to other pathogens demonstrates the urgency for an improved understanding of enterococcal virulence mechanisms, and the development of alternative treatment and prevention options. This article reviews new antimicrobials, vaccine targets, bacteriophage therapy, as well as treatments targeting virulence factors and biofilm, for their potential to treat and/or prevent enterococcal infections. Although clinical isolates often cause serious infections, so-called 'non-pathogenic' strains are used as therapeutics in the form of probiotics. Understanding the differences between true pathogens and beneficial commensals may help to evaluate future treatment and prophylactic options.
authors.affiliation: Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, 181 Longwood Ave, Boston, MA 02115, USA.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Koch
authors.forename: Markus
authors.initials: M
authors.lastname: Hufnagel
authors.forename: Johannes
authors.initials: J
authors.lastname: Huebner
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology; D001428:Bacterial Vaccines / Q000276:immunology; D001435:Bacteriophages / Q000502:physiology; D018441:Biofilms; D001691:Biological Therapy; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy; D004351:Drug Resistance; D016983:Enterococcus / Q000187:drug effects / Q000276:immunology / Q000472:pathogenicity / Q000821:virology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy* / Q000635:transmission; D006801:Humans; D008297:Male; D019936:Probiotics / Q000627:therapeutic use; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001428:Bacterial Vaccines