Cave enterococcum!

Molecular epidemiology indicates that epidemic clones of E. faecalis are emerging which are well-adapted to hospital environments, and whose spread poses a major threat. These clones usually exhibit multi-resistances, particularly toward aminoglycosides and erythromycin, and even to vancomycin, as was reported from the US and Europe. The pathogenicity of enterococci is probably not related to virulence factors in the classical sense but rather to a combination of “fitness factors”, such as increased resistance to antimicrobials and environmental stresses, as well as specific and unspecific adhesive properties. While biofilm formation of enterococci has been observed clinically and in the laboratory, there is to date no consensus on the nature of the biofilm matrix and the molecular mechanisms involved in adhesion to biotic and/or abiotic surfaces. Several surface proteins and surface carbohydrates have been implicated, but no convincing strategies for specific treatments or preventive measures are on the horizon.