From the Guidelines
Vaginal Enterococcus infection is a significant concern due to its potential to cause severe morbidity and mortality, particularly in cases where the bacteria access sterile areas of the reproductive tract or when there's an imbalance in the vaginal flora. Enterococcus is a genus of bacteria that can be found in the vaginal flora, with common species including Enterococcus faecalis and Enterococcus faecium 1. If you're experiencing vaginal symptoms and Enterococcus has been identified, treatment typically involves antibiotics based on susceptibility testing.
Key Considerations
- Common antibiotics used for Enterococcus infections include ampicillin (500 mg orally four times daily for 7-10 days) or amoxicillin (500 mg orally three times daily for 7-10 days) 1.
- For resistant strains, vancomycin or linezolid might be necessary, as Enterococci are relatively resistant to penicillin, ampicillin, and vancomycin 1.
- It's essential to complete the full course of antibiotics even if symptoms improve.
- During treatment, maintaining good hygiene, wearing cotton underwear, and avoiding douching are crucial.
- Enterococcus can be part of normal vaginal flora but may cause infection when there's an imbalance or if the bacteria access sterile areas of the reproductive tract.
Importance of Proper Diagnosis and Treatment
- If you're experiencing symptoms like unusual discharge, odor, itching, or pain, please consult a healthcare provider for proper diagnosis and treatment tailored to your specific situation.
- The choice of empiric antibiotic regimens in patients with intra-abdominal infections, including those caused by Enterococcus, should be based on the clinical condition of the patients, the individual risk for infection by resistant pathogens, and the local resistance epidemiology 1.
- In cases of healthcare-associated infections, antimicrobial therapy should be started as soon as possible, and the selection of a pharmacological agent with penetration to the site of presumed infection is necessary 1.
Resistance and Treatment Challenges
- The acquisition of glycopeptide resistance by enterococci has seriously affected the treatment and control of these organisms 1.
- Affected patients usually have multiple and relevant co-morbidities, with prolonged hospital stay and received long courses of broad-spectrum antibiotics 1.
- The use of carbapenems should be limited to preserve the activity of this class of antibiotics due to the concern of emerging carbapenem-resistance 1.
From the Research
Significance of Vaginal Enterococcus Infection
- Vaginal Enterococcus infection is a type of bacterial infection that can cause significant health issues, particularly in patients with compromised immune systems 2, 3.
- Enterococci are known to develop resistance to antibiotics, making treatment challenging 2, 3, 4.
- Vancomycin-resistant Enterococcus (VRE) is a major concern, as it can lead to severe infections and limited treatment options 3, 4, 5.
Treatment Options
- Treatment options for VRE infections include antibiotics such as linezolid, daptomycin, and quinupristin/dalfopristin 2, 3, 4.
- Combination therapies, including β-lactams and fosfomycin, have shown promising results in treating VRE faecium infections 5.
- For aerobic vaginitis, treatment may involve local antibiotics, steroids, and/or estrogen, depending on the severity of the infection and the presence of other microorganisms 6.
Complications and Risks
- Vaginal Enterococcus infection can lead to complications such as urinary tract infections, intra-abdominal infections, and bloodstream infections 2.
- The development of antibiotic resistance in Enterococci can limit treatment options and increase the risk of severe infections 2, 3, 4.
- In severe cases, vaginal Enterococcus infection can lead to desquamative inflammatory vaginitis, a condition characterized by epithelial atrophy and inflammation 6.