Enterococcus faecium

Gram Stain

• Gram positive cocci in pairs and short chains (aerobic)

Clinical Significance

This organism is part of the commensal flora of the gastrointestinal tract and is widely distributed in the environment (soil/water/plants/animals).

It is associated with endocarditis, intra-abdominal/pelvic infections, and urinary tract infections (commonly in persons with structural abnormalities or following urologic instrumentation).

It is an important cause of nosocomial infections, especially of the urinary tract.

Usual Susceptibility Pattern

This organism is typically susceptible to vancomycin and linezolid.

Vancomycin resistance is usually associated with nosocomial infections.

Ampicillin resistance is found in 90% of isolates.

E. faecium is resistant to cephalosporins, clindamycin, macrolides, tetracyclines, quinolones, fusidic acid, and TMP/SMX.

Daptomycin, although typically testing as susceptible, should only be used at high dose with close clinical follow-up as therapeutic failures can occur even when testing susceptible.