Faecalis Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Faecalis and links to relevant pages within the course.
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| Match the Streptococcal organism with the appropriate group. | View Page |
| Enterococcus faecium ID As a high percentage of Enterococcus faecium strains carry the Van A gene and are highly resistant to vancomycin. Species identifications are performed in some laboratories where MIC susceptibility testing may not be available.Methods for the phenotypic separation of E. faecium from E. faecalis are limited.Illustrated in this photograph are positive reactions for acid production from arabinose and melibiose (yellow color), characteristic of E. faecium. E. faecalis are negative for these reactions.A few preformed substrates such as beta galactosidase (E. faecium positive, E. faecalis negative) also serve to separate these two species, accomplished by certain commercial systems that include these substrates.E. faecium is not motile, an additional characteristic helpful to separate vancomycin-resistant Enterococcus species from E. cassiloflavus and E. gallinarum, both of which are motile, and carry the low level resistant gene VAN-c. | View Page |
| Vancomycin Resistance Vancomycin and ampicillin resistance among Enterococcus species, particularly E. faecium have been on a steady increase.The disk diffusion screening test is used in many laboratories to detect vancomycin resistant strains. Note in the upper photograph that no zone of inhibition is seen around either the vancomycin or the ampicillin disk, indicating resistance to both drugs.Vancomycin-resistant Enterococci (VRE) have been divided into three phenotypes--Van A, Van B, and Van C.Vancomycin-resistant strains of E. faecalis and E. faecium are commonly of the Van A phenotype, demonstrating high level resistance (MIC's higher than 64 ug/mL), as illustrated by total resistance of the test strain in the E test and the VA disk, as illustrated in the lower photograph.The strain shown in the lower photograph, however, is ampicillin susceptible at the level of 1 ug/ml (see lower set of yellow arrows), indicating that this drug may be effective in treating the urinary tract infection. | View Page |
| Review 2 Suppola JP. Kuikka A. Vaara M. Valtonen VV.
Comparison of risk factors and outcome in patients with Enterococcus faecalis vs Enterococcus faecium bacteremia.
Scandinavian Journal of Infectious Diseases. 30(2):153-7, 1998.The purpose of our study was to determine retrospectively the risk factors for the acquisition of Enterococcus faecalis vs E. faecium bacteremia, as well as the clinical outcomes of these patients.62 patients with Enterococcus faecalis bacteremia were compared to 31 patients with E. faecium bacteremia. Haematologic malignancies, neutropenia, high-risk source and previous use of aminoglycosides, carbapenems, cephalosporins and clindamycin were significantly associated with E. faecium bacteremia. Instead, urinary catheterization was found to be related to Enterococcus faecalis bacteremia. The mortality rates within 7 d and 30 d were 13% and 27%, respectively, in patients with E. faecalis bacteremia and 6% and 29%, respectively, in patients with E. faecium bacteremia.There was no difference in mortality between E. faecalis and E. faecium bacteremia, nor was there a difference in seriousness of disease at the time of bacteremia. In the subgroups of patients with monomicrobial or clinically significant E. faecalis vs E. faecium bacteremia, the mortality rates were similar to the results of all subjects.Our results do not support the theory that E. faecium would be a more virulent organism than E. faecalis | View Page |
| Illustrated in the upper photograph are tiny pinpoint 24-hour colonies recovered from one of the splenic abscesses. The wide zones of beta hemolysis are better seen in the close-in view of the 36 hour culture shown in the lower photograph.
Streptococcus milleri (anginosus) can be suspected if one of the following odors is detected: | View Page |