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Pathogenicity of Enterococci

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  • Authors: Elizabeth Fiore1,2, Daria Van Tyne3,4, Michael S. Gilmore5,6
  • Editors: Vincent A. Fischetti7, Richard P. Novick8, Joseph J. Ferretti9, Daniel A. Portnoy10, Miriam Braunstein11, Julian I. Rood12
    Affiliations: 1: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114; 2: Department of Microbiology, Harvard Medical School, Boston, MA 02115; 3: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114; 4: Department of Microbiology, Harvard Medical School, Boston, MA 02115; 5: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114; 6: Department of Microbiology, Harvard Medical School, Boston, MA 02115; 7: The Rockefeller University, New York, NY; 8: Skirball Institute for Molecular Medicine, NYU Medical Center, New York, NY; 9: Department of Microbiology & Immunology, University of Oklahoma Health Science Center, Oklahoma City, OK; 10: Department of Molecular and Cellular Microbiology, University of California, Berkeley, Berkeley, CA; 11: Department of Microbiology and Immunology, University of North Carolina-Chapel Hill, Chapel Hill, NC; 12: Infection and Immunity Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Australia
  • Source: microbiolspec July 2019 vol. 7 no. 4 doi:10.1128/microbiolspec.GPP3-0053-2018
  • Received 24 August 2018 Accepted 10 December 2018 Published 12 July 2019
  • Michael S. Gilmore, [email protected]
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  • Abstract:

    Enterococci are unusually well adapted for survival and persistence in a variety of adverse environments, including on inanimate surfaces in the hospital environment and at sites of infection. This intrinsic ruggedness undoubtedly played a role in providing opportunities for enterococci to interact with other overtly drug-resistant microbes and acquire additional resistances on mobile elements. The rapid rise of antimicrobial resistance among hospital-adapted enterococci has rendered hospital-acquired infections a leading therapeutic challenge. With about a quarter of a genome of additional DNA conveyed by mobile elements, there are undoubtedly many more properties that have been acquired that help enterococci persist and spread in the hospital setting and cause diseases that have yet to be defined. Much remains to be learned about these ancient and rugged microbes, particularly in the area of pathogenic mechanisms involved with human diseases.

  • Citation: Fiore E, Van Tyne D, Gilmore M. 2019. Pathogenicity of Enterococci. Microbiol Spectrum 7(4):GPP3-0053-2018. doi:10.1128/microbiolspec.GPP3-0053-2018.


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Enterococci are unusually well adapted for survival and persistence in a variety of adverse environments, including on inanimate surfaces in the hospital environment and at sites of infection. This intrinsic ruggedness undoubtedly played a role in providing opportunities for enterococci to interact with other overtly drug-resistant microbes and acquire additional resistances on mobile elements. The rapid rise of antimicrobial resistance among hospital-adapted enterococci has rendered hospital-acquired infections a leading therapeutic challenge. With about a quarter of a genome of additional DNA conveyed by mobile elements, there are undoubtedly many more properties that have been acquired that help enterococci persist and spread in the hospital setting and cause diseases that have yet to be defined. Much remains to be learned about these ancient and rugged microbes, particularly in the area of pathogenic mechanisms involved with human diseases.

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Image of FIGURE 1

Animal hosts that have been associated with enterococcal colonization. A simplified tree of life with blue shading indicating animals from which enterococci have been isolated. Corresponding geologic periods are indicated on the left. Reproduced with permission from reference 11 .

Source: microbiolspec July 2019 vol. 7 no. 4 doi:10.1128/microbiolspec.GPP3-0053-2018
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Image of FIGURE 2

Routes of dissemination of enterococci from the intestinal reservoir of a hospitalized patient. Bacteria from the intestine can seed infections throughout the body and contaminate surfaces, leading to patient-to-patient spread. Reproduced with permission from reference 122 .

Source: microbiolspec July 2019 vol. 7 no. 4 doi:10.1128/microbiolspec.GPP3-0053-2018
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Population structure of and based on comparisons of whole genomes. RAxML tree of 1,344 single copy core genes found in 73 genomes, showing the clade structure of the population. Reproduced with permission from reference 104 . Phylogeny of 515 isolates based on 1,293 conserved core genes found in 99% of isolates. The L1, L2, and L3 lineages are highlighted with red, purple, and turquoise lines, respectively. Reproduced with permission from reference 250 .

Source: microbiolspec July 2019 vol. 7 no. 4 doi:10.1128/microbiolspec.GPP3-0053-2018
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Enterococcal virulence factors

Source: microbiolspec July 2019 vol. 7 no. 4 doi:10.1128/microbiolspec.GPP3-0053-2018

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