Colonies of Enterococcus faecalis reside in the intestinal tracts of all people from shortly after birth. Rarely, a strain of Enterococcus faecalis will become pathogenic and cause one of a number of serious infections in an individual. This typically happens in hospitalized patients, and treating an infection caused by Enterococcus faecalis often proves difficult.
Mutation Leads to Pathogenicity
Enterococcus faecalis bacteria of the V583 strain become problematic when they contain a genetic mutation that allows them attack human tissues. This mutation involves the deletion of genes on bacterium's chromosome 17, according to research reported in the online journal BMC Genomics on April 19, 2009.
Mutated Enterococcus faecalis can cause post-surgical infections of the abdominal wall, injection site infections of the skin, meningitis, urinary tract infections, bacterimia (blood poisoning), and endocarditis (swelling of the inner lining of the heart). Some 12 percent of the 28,502 hospital-acquired infections reported to Centers for Disease Control and prevention during 2006 and 2007 were caused by Enterococcus bacteria.
The specific symptoms of an Enterococcus faecalis infection will vary according to which organs become infected. General symptoms of bacterial infections include fever, lack of energy, pain in the infected area and weakness. Skin infections can cause redness and itching, while meningitis can cause neck stiffness, excessive sleepiness and loss of appetite. Patients with bacterimia experience chills and low blood pressure, while people suffering from endocarditis will be short of breath, have night sweats and have irregular heartbeats.
Enterococcus faecalis bacteria prove resistant to most antibiotics. Long-term administration of medications classified as aminoglycoside and cell wall-active antibiotics (e.g., amoxicillin, ceftriaxone) can clear Enterococcus faecalis infections, but they may give rise to secondary infections because the medications kill off beneficial bacteria that protect the body. Also, aminoglycosides such as neomycin and gentamicin can produce hearing loss and kidney damage.
The CDC issued more than 150 pages of guidelines for preventing hospital-acquire, or nosocomial, infections in 2008. What those guidelines boil down to is that hospital personal must conscientiously clean, disinfect and sterilize all surfaces and equipment. However, since most Enterococcus faecalis bacteria-caused infections arise from bacteria that come from a patient's own body, taking antibiotics before and possibly after surgery may be recommended for patients undergoing procedures that pose high infection risk, such as dental surgery or gastrointestinal surgery.