Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics

• Published in: Antimicrobial resistance & infection control Vol. 9; no. 1; p. 130
• Main Authors: Zhou, Xuewei, Willems, Rob J L, Friedrich, Alexander W, Rossen, John W A, Bathoorn, Erik
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10-08-2020; BioMed Central; BMC
• Subjects: Anti-Bacterial Agents - pharmacology; Antibacterial agents; Antibiotics; Antimicrobial agents; Bacterial Typing Techniques; Cross Infection - epidemiology; Cross Infection - microbiology; Diagnostics; Disease control; Disease Outbreaks; Disease transmission; Drug resistance; Enterococcus faecium; Enterococcus faecium - drug effects; Epidemiology; Evolution; Genes; Genome, Bacterial; Genomes; Genomics; Genotype; Gram-Positive Bacterial Infections - diagnosis; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - prevention & control; Health aspects; Health facilities construction; Hospitals; Humans; Infection; Infection control; Infection Control - methods; Microbial drug resistance; Microbial Sensitivity Tests; Microbiology; Multilocus Sequence Typing; Nosocomial infections; Pathogens; Prevention; Review; Streptococcus infections; Surveillance; VRE; Australia; Eastern Europe; Netherlands; Romania; Cyprus; Hungary; United States > US; Europe; Spain; Sweden; Latvia; Poland; Slovakia; France; Lithuania; Bulgaria; Germany; Croatia; VRE; Enterococcus faecium; Evolution; Diagnostics; Infection control
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-020-00770-1

Early in its evolution, Enterococcus faecium acquired traits that allowed it to become a successful nosocomial pathogen. E. faecium inherent tenacity to build resistance to antibiotics and environmental stressors that allows the species to thrive in hospital environments. The continual wide use of antibiotics in medicine has been an important driver in the evolution of E. faecium becoming a highly proficient hospital pathogen.For successful prevention and reduction of nosocomial infections with vancomycin resistant E. faecium (VREfm), it is essential to focus on reducing VREfm carriage and spread. The aim of this review is to incorporate microbiological insights of E. faecium into practical infection control recommendations, to reduce the spread of hospital-acquired VREfm (carriage and infections). The spread of VREfm can be controlled by intensified cleaning procedures, antibiotic stewardship, rapid screening of VREfm carriage focused on high-risk populations, and identification of transmission routes through accurate detection and typing methods in outbreak situations. Further, for successful management of E. faecium, continual innovation in the fields of diagnostics, treatment, and eradication is necessary.