Table of ContentsView AllTable of ContentsWhat Is Enterococcus Faecalis?CausesSymptoms and InfectionsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is Enterococcus Faecalis?
Causes
Symptoms and Infections
Diagnosis
Treatment
Enterococcus faecalis(E. faecalis) is a species of enterococci bacteria that normally lives in your gastrointestinal (GI) tract and can also be found in the oral cavity and vaginal tract.
AlthoughE. faecalisusually isn’t harmful to the human body, it can become an opportunistic pathogen—causing disease when a person’s immune defenses are low. For this reason,E. faecalisis considered an opportunistic pathogen. Out of all the enterococci species, itis the most common cause of urinary tract infections.
This article explains the causes and symptoms ofenterococcus faecalisinfections, as well as how these infections are treated.
PASIEKA / Getty Images
At least 50 different species of enterococci bacteria have been described in medical literature.Among them, the speciesEnterococcus faecaliscauses the majority of infections and is a leading cause of nosocomial (hospital-acquired) infections.
E. faecaliscan enter the body during surgery, through insufficiently cleaned medical devices and equipment, improper hand hygiene, or ingesting contaminated foods and fluids.
CommonE. faecalisinfections includeurinary tract infections (UTIs), wound infections, intra-abdominal and pelvic infections,bacteremia(infection in the blood), andendocarditis(inflammation of the heart). If these infections become systemic (widespread), they can cause serious to life-threatening symptoms.
Enterococcus faecalisis a tenacious species of bacteria that is growing increasingly resistant to antibiotics. The bacterium is capable of forming “microbial communities,” in which it attaches to other microbial cells to form what’s known as a biofilm. These biofilms are especially resistant to antibiotic therapy.
Being that it is an opportunistic pathogen,Enterococcus faecalisis harmless to most people with healthy immune systems, but it does pose a threat to the elderly as well as those who are immunocompromised (have weakened immune systems).
What Causes Enterococcus Faecalis?
Improper Hand Hygiene
According to the Centers for Disease Control and Prevention (CDC), about 1 in 31 hospital patients has at least one healthcare-associated infection on a daily basis.
What Is the Best Way to Pop a Pimple?
Biofilm Formation on Medical Devices and Equipment
The use of intravenous orurinary catheters,pacemakers, or heart valves increases the risk of biofilm formation (growth and adherence of bacteria communities on surfaces). Even when properly sterilized before placement, they can become infected through bacteremia after they are in the body.
Biofilms have a dense 3D extracellular matrix which can be difficult to remove from surfaces. This increases their resistance to antibiotics, which can cause life-threatening infections in the body.
Contaminated Foods and Liquids
E. faecalisis commonly found in soil, water, plants, and animals. Eating unwashed foods can increase the risk of infection.
Symptoms and Types of Infections
Urinary Tract Infections (UTIs)
Common symptoms of UTIs include:
Symptoms of a Urinary Tract Infection
Who’s More Susceptible to UTIs?Risk factors for bladder infections include previous UTIs, sexual activity, older age, bladder emptying issues, an obstruction in the urinary tract (urinary stoneor enlarged prostate), or use of a urinary catheter.
Who’s More Susceptible to UTIs?
Risk factors for bladder infections include previous UTIs, sexual activity, older age, bladder emptying issues, an obstruction in the urinary tract (urinary stoneor enlarged prostate), or use of a urinary catheter.
Bacteremia
Bacteremia occurs when bacteria get into the blood, often from a wound site or untreated UTI.If left untreated, bacteremia can lead to life-threatening conditions, such as endocarditis,sepsis(a systemic reaction to a blood infection), andseptic shock(low blood pressure in severe sepsis that can cause organ failure).
Common symptoms of bacteremia include:
Bacteremia Causes and Diagnosis
Endocarditis
Endocarditis is a rare and potentially fatal condition that involves the inflammation of the inner lining of the heart (endocardium) and its valves.E. faecalisendocarditis typically occurs as a complication of bacteremia, where bacteria in the bloodstream travels to the heart.
Enterococcus is the third most common organism to cause endocarditis and is most often seen in cases acquired in healthcare settings.Other risk factors include having an artificial heart valve, cardiac pacemaker leads, or damaged heart valves.
Common symptoms of endocarditis may develop slowly or suddenly. They include:
Endocarditis is a rare and potentially fatal condition. If you experience symptoms of endocarditis, seek immediate medical attention.
How Is Enterococcus Faecalis Diagnosed?
In the laboratory, methods will be used to see if bacteria grow from the samples. Those samples will be tested to see what antibiotics will or won’t work to treat the infection.
Can Enterococcus Faecalis Be Cured?
Ampicillin, anantibiotic, is commonly used to treatE. faecalisinfections.Ampicillin blocks the formation of the external cell wall ofE. faecalis, causing them to die.
However,E. faecalisinfections are generally very difficult to treat due to their possible resistance to several antibiotics, including vancomycin, daptomycin, aminoglycosides, and more.
For severe infections, such as endocarditis, combination antibiotics are used to increase their potency. This may include the combination of penicillin and gentamicin.That said, researchers are investigating other antibiotics that may be more effective for treatingE. faecalisinfections.
If the bacteria is resistant to vancomycin, healthcare providers may take extra precautions to prevent spreading it to other patients.These can include wearing a disposable gown when bathing the patient or handling soiled linens or diapers.
Standard precautions of wearing disposable gloves and handwashing before and after caring for the patient should also be followed diligently. Toilets and bed rails should be disinfected with a bleach solution.
Can Probiotics Treat or Prevent Bacterial Infections?
Summary
Enterococcus faecalisis a species of bacteria that live harmlessly in the digestive tract, although some can be found in the oral cavity or vaginal tract.E. faecalishas the potential to become pathogenic (disease-causing) in people who are immunocompromised.
E. faecalisinfections are typically nosocomial (hospital-acquired). CommonE. faecalisinfections include urinary tract infections (UTIs), bacteremia, and endocarditis. If these infections become systemic, they can cause serious to life-threatening symptoms.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anderson AC, Jonas D, Huber I, et al.Enterococcus faecalis from food, clinical specimens, and oral sites: prevalence of virulence factors in association with biofilm formation.Front Microbiol. 2016;6(1):1-14. doi:10.3389/fmicb.2015.01534Hashem YA, Abdelrahman KA, Aziz RK.Phenotype-genotype correlations and distribution of key virulence factors inEnterococcus faecalisisolated from patients with urinary tract infections.Infect Drug Resist. 2021 May;2021(1):1713-1723. doi:10.2147/IDR.S305167Zhou X, Willems R, Friedrich A, Rossen J, Bathoorn E.Enterococcus faecium: From microbiological insights to practical recommendations for infection control and diagnostics.Antimicrob Resist Infect Control. 2020 Aug;9(1):130. doi:10.1186/s13756-020-00770-1Del Turco ER, Bartoletti M, Dahl A, Cervera C, Pericàs J.How do I manage a patient with enterococcal bacteraemia?.Clin Microbiol Infect. 2020 Nov;27(3):364-371. doi:10.1016/j.cmi.2020.10.029Jabbari Shiadeh SM, Pormohammad A, Hashemi A, Lak P.Global prevalence of antibiotic resistance in blood-isolated Enterococcus faecalis and Enterococcus faecium: a systematic review and meta-analysis.Infection and Drug Resistance. 2019;12:2713-2725. doi:10.2147/IDR.S206084Agudelo Higuita NI, Huycke MM.Enterococcal disease, epidemiology, and implications for treatment.In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds.Enterococci: From Commensals to Leading Causes of Drug Resistant Infection. Massachusetts Eye and Ear Infirmary; 2014.Centers for Disease Control and Prevention.About hand hygiene for patients in healthcare settings.Lin E, Bhusal Y, Horwitz D, Shelburne SA, Trautner BW.Overtreatment of enterococcal bacteriuria.JAMA Internal Medicine.2012;172(1):33. doi:10.1001/archinternmed.2011.565National Institute of Diabetes and Digestive and Kidney Diseases.What is a bladder infection?National Organization for Rare Diseases.Infective endocarditis.Penn Medicine.Endocarditis.Kristich CJ, Rice LB, Arias CA.Enterococcal Infection—Treatment and Antibiotic Resistance.Massachusetts Eye and Ear Infirmary; 2014.New York State Department of Health.Vancomycin-resistant enterococcus (VRE).
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anderson AC, Jonas D, Huber I, et al.Enterococcus faecalis from food, clinical specimens, and oral sites: prevalence of virulence factors in association with biofilm formation.Front Microbiol. 2016;6(1):1-14. doi:10.3389/fmicb.2015.01534Hashem YA, Abdelrahman KA, Aziz RK.Phenotype-genotype correlations and distribution of key virulence factors inEnterococcus faecalisisolated from patients with urinary tract infections.Infect Drug Resist. 2021 May;2021(1):1713-1723. doi:10.2147/IDR.S305167Zhou X, Willems R, Friedrich A, Rossen J, Bathoorn E.Enterococcus faecium: From microbiological insights to practical recommendations for infection control and diagnostics.Antimicrob Resist Infect Control. 2020 Aug;9(1):130. doi:10.1186/s13756-020-00770-1Del Turco ER, Bartoletti M, Dahl A, Cervera C, Pericàs J.How do I manage a patient with enterococcal bacteraemia?.Clin Microbiol Infect. 2020 Nov;27(3):364-371. doi:10.1016/j.cmi.2020.10.029Jabbari Shiadeh SM, Pormohammad A, Hashemi A, Lak P.Global prevalence of antibiotic resistance in blood-isolated Enterococcus faecalis and Enterococcus faecium: a systematic review and meta-analysis.Infection and Drug Resistance. 2019;12:2713-2725. doi:10.2147/IDR.S206084Agudelo Higuita NI, Huycke MM.Enterococcal disease, epidemiology, and implications for treatment.In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds.Enterococci: From Commensals to Leading Causes of Drug Resistant Infection. Massachusetts Eye and Ear Infirmary; 2014.Centers for Disease Control and Prevention.About hand hygiene for patients in healthcare settings.Lin E, Bhusal Y, Horwitz D, Shelburne SA, Trautner BW.Overtreatment of enterococcal bacteriuria.JAMA Internal Medicine.2012;172(1):33. doi:10.1001/archinternmed.2011.565National Institute of Diabetes and Digestive and Kidney Diseases.What is a bladder infection?National Organization for Rare Diseases.Infective endocarditis.Penn Medicine.Endocarditis.Kristich CJ, Rice LB, Arias CA.Enterococcal Infection—Treatment and Antibiotic Resistance.Massachusetts Eye and Ear Infirmary; 2014.New York State Department of Health.Vancomycin-resistant enterococcus (VRE).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Anderson AC, Jonas D, Huber I, et al.Enterococcus faecalis from food, clinical specimens, and oral sites: prevalence of virulence factors in association with biofilm formation.Front Microbiol. 2016;6(1):1-14. doi:10.3389/fmicb.2015.01534Hashem YA, Abdelrahman KA, Aziz RK.Phenotype-genotype correlations and distribution of key virulence factors inEnterococcus faecalisisolated from patients with urinary tract infections.Infect Drug Resist. 2021 May;2021(1):1713-1723. doi:10.2147/IDR.S305167Zhou X, Willems R, Friedrich A, Rossen J, Bathoorn E.Enterococcus faecium: From microbiological insights to practical recommendations for infection control and diagnostics.Antimicrob Resist Infect Control. 2020 Aug;9(1):130. doi:10.1186/s13756-020-00770-1Del Turco ER, Bartoletti M, Dahl A, Cervera C, Pericàs J.How do I manage a patient with enterococcal bacteraemia?.Clin Microbiol Infect. 2020 Nov;27(3):364-371. doi:10.1016/j.cmi.2020.10.029Jabbari Shiadeh SM, Pormohammad A, Hashemi A, Lak P.Global prevalence of antibiotic resistance in blood-isolated Enterococcus faecalis and Enterococcus faecium: a systematic review and meta-analysis.Infection and Drug Resistance. 2019;12:2713-2725. doi:10.2147/IDR.S206084Agudelo Higuita NI, Huycke MM.Enterococcal disease, epidemiology, and implications for treatment.In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds.Enterococci: From Commensals to Leading Causes of Drug Resistant Infection. Massachusetts Eye and Ear Infirmary; 2014.Centers for Disease Control and Prevention.About hand hygiene for patients in healthcare settings.Lin E, Bhusal Y, Horwitz D, Shelburne SA, Trautner BW.Overtreatment of enterococcal bacteriuria.JAMA Internal Medicine.2012;172(1):33. doi:10.1001/archinternmed.2011.565National Institute of Diabetes and Digestive and Kidney Diseases.What is a bladder infection?National Organization for Rare Diseases.Infective endocarditis.Penn Medicine.Endocarditis.Kristich CJ, Rice LB, Arias CA.Enterococcal Infection—Treatment and Antibiotic Resistance.Massachusetts Eye and Ear Infirmary; 2014.New York State Department of Health.Vancomycin-resistant enterococcus (VRE).
Anderson AC, Jonas D, Huber I, et al.Enterococcus faecalis from food, clinical specimens, and oral sites: prevalence of virulence factors in association with biofilm formation.Front Microbiol. 2016;6(1):1-14. doi:10.3389/fmicb.2015.01534
Hashem YA, Abdelrahman KA, Aziz RK.Phenotype-genotype correlations and distribution of key virulence factors inEnterococcus faecalisisolated from patients with urinary tract infections.Infect Drug Resist. 2021 May;2021(1):1713-1723. doi:10.2147/IDR.S305167
Zhou X, Willems R, Friedrich A, Rossen J, Bathoorn E.Enterococcus faecium: From microbiological insights to practical recommendations for infection control and diagnostics.Antimicrob Resist Infect Control. 2020 Aug;9(1):130. doi:10.1186/s13756-020-00770-1
Del Turco ER, Bartoletti M, Dahl A, Cervera C, Pericàs J.How do I manage a patient with enterococcal bacteraemia?.Clin Microbiol Infect. 2020 Nov;27(3):364-371. doi:10.1016/j.cmi.2020.10.029
Jabbari Shiadeh SM, Pormohammad A, Hashemi A, Lak P.Global prevalence of antibiotic resistance in blood-isolated Enterococcus faecalis and Enterococcus faecium: a systematic review and meta-analysis.Infection and Drug Resistance. 2019;12:2713-2725. doi:10.2147/IDR.S206084
Agudelo Higuita NI, Huycke MM.Enterococcal disease, epidemiology, and implications for treatment.In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds.Enterococci: From Commensals to Leading Causes of Drug Resistant Infection. Massachusetts Eye and Ear Infirmary; 2014.
Centers for Disease Control and Prevention.About hand hygiene for patients in healthcare settings.
Lin E, Bhusal Y, Horwitz D, Shelburne SA, Trautner BW.Overtreatment of enterococcal bacteriuria.JAMA Internal Medicine.2012;172(1):33. doi:10.1001/archinternmed.2011.565
National Institute of Diabetes and Digestive and Kidney Diseases.What is a bladder infection?
National Organization for Rare Diseases.Infective endocarditis.
Penn Medicine.Endocarditis.
Kristich CJ, Rice LB, Arias CA.Enterococcal Infection—Treatment and Antibiotic Resistance.Massachusetts Eye and Ear Infirmary; 2014.
New York State Department of Health.Vancomycin-resistant enterococcus (VRE).
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
