Enterococcus, particularly E. faecium and E. faecalis, are responsible for many hospital-acquired infections. With their intrinsic antibiotic resistance and ability to form biofilms, enterococcal infections are already challenging to manage. However, when heterogenous populations are present, such as those exhibiting heteroresistance and persistence, the complexity of these infections increases exponentially not only due to their treatment but also due to their difficult diagnosis. In this study, we provide a summary of the current understanding of both heteroresistance and persistence in terms of mechanisms, diagnosis and treatment and subsequently review recent literature pertaining to these susceptibility types specifically in enterococci.
Keywords: Enterococcus; antibiotic resistance; heteroresistance; hospital-acquired infections; persistence; recurrent infections.
Some bacteria are common causes of illness among hospital patients. Some of these infections are very difficult to treat, as the bacteria can respond differently to antibiotics. This review looks at how a type of bacteria called Enterococcus can respond differently to antibiotics, and how we can diagnose or kill them more easily.