Enterococcus

Specii:-faecalis 80-90%
- faecium 5-10%
- durans

Habitat: face parte din mictobiota indigena a adultului

 mucoasa intestinala (colon),
 genito-urinara (vagin),
 ocazional faringele.

Patologii determinate :

 Singuri: infectii urinare, endocardite infecrioase, meningite

 In asociere cu enterobacteriacee si bacterii anaerobe: peritonite,
infectii biliare, abcese hepatice, infectii ale plagilor chirurgicale

Antibioterapie:

 Rezistenta naturala: cefalosporine, lincosamide, sinergistine

Rezistenta la Peniciline Glicopeptide(Vanco)

Enterococ vanco-rezistent, intermittent Oxazolidinone sau

Enterococ vanco-rezistent Glicilcicline(Tigeciclin) sau

Rez. Glicoppetide Quinupristina/ Dalfopristina

Clasa Exemple Doze adult Doze copil
Ampicilina po. 2-4g/zi 100mg/zi
Aminopeniciline im.iv. 4-12g/zi 100-300mg/zi
Amoxicilina po.im.iv. 1-8g/zi 25-200mg/kg/zi

Acid clavulanic 2-3g/zi 30-40mg/kg/zi

Ureidopeniciline Piperacilina 6-15g/zi 100-300mg/kg/zi
Carbapeneme Imipenem iv. 2g/zi 30-60 mg/kg/zi
(faecalis)
Vancomicina iv. 1,5-2 g/12h 0-30zile -15mg/kg/zi
Glicopeptide
Teicoplanin 200-400mg/zi >30zile -10mg/kg/zi
Oxazolidinone Linezolid 600mg x 2/zi sau 25 mg/kg/zi
Glicilcicline Tigeciclin

Streptogramine Quinupristina
7,5 mg/kg iv la 8h
(faecium) Dalfopristina
Sulfonamide Sulfametoxazol 400mg
(faecalis)
Nitrofurani Nitrofurantoin
Aminoglicozide Efect sinergic cu peniciline sau glicopeptide