title: Transition of Enterococcus faecium from commensal organism to nosocomial pathogen.
abstract: The Gram-positive species Enterococcus faecium has long been thought of as a harmless commensal of the mammalian GI tract. In the last two decades, however, E. faecium has become an important cause of nosocomial bacteremias. These infections are often difficult to treat owing to the resistance of E. faecium to a large number of antibiotics. In this article, we review the recent transition of E. faecium from commensal to nosocomial pathogen. We focus on population biology-based studies, which suggest that several clonal populations of E. faecium are mostly responsible for causing infections. We also discuss the role of the accessory genome of E. faecium in contributing to the infectious phenotype and examine the role that surface proteins of E. faecium may have in colonization and infection.
authors.affiliation: Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan, CX Utrecht, The Netherlands. rwillems@umcutrecht.nl
authors.forename: Rob Jl
authors.initials: RJ
authors.lastname: Willems
authors.forename: Willem
authors.initials: W
authors.lastname: van Schaik
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D016984:Enterococcus faecium / Q000472:pathogenicity* / Q000502:physiology; D016680:Genome, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008565:Membrane Proteins / Q000378:metabolism; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents; D008565:Membrane Proteins