Enterococcus faecium

1. JENIFER LÓPEZ ECHEVERRY
MEDICINE STUDENT
MARÍA CLARA OCHOA
MEDICINE STUDENTMOLECULAR BIOLOGY

2. INTRODUCTION

3. Enterococcus Faecium
G: Coccus E: Faecium
It can be found in
normal flora
It has a natural
resistance to
antibiotics
It is used as a
probiotic in the
industry

4. DISEASES
• Urinary tract infection
• Chronic prostatitis
• Bacterial endocarditis
• Meningitis
• Soft tissiue infections
• Neonatal infections

5. HEMATOLOGIC
MALIGNANCIES
• Chromosomal translocations are a common
cause of these diseases.
• Generally a disease affecting one type of cell
will often affect the others as well.
• Hematological malignancies may derive from
either of the two major blood cell lineages.

6. R
E
L
A
T
I
O
N
Colonization of gastrointestinal
tract by E. faecium
Immunocompromised patients
-
Infectious complications are one of
the main causes of mortality in
patients with cancer
Hematologic
Malignancies
E.
faecium

7. HEMATOLOGIC
MALIGNANCIES
LYMPHOMAS
-
MYELOPROLIFERATIVE
DISORDES
NO HODKING
LYMPHOMA
HODKING
LYMPHOMA
POLYCYTHEMIA
VERA
CHRONIC IDIOPATIC
MYELOFIBROSIS
ACUTE
LYMPHOBLASTIC
LEUKEMIA
ACUTE
MYELOID
LEUKEMIA

8. Evaluate the clinical features and outcome of patients with
vancomycin-sensitive E faecium (VSEf) and VREf BSI, to
outline the resistance patterns of E faecium, and to
determine their genetic relatedness by pulsed field gel
electrophoresis (PFGE).
GENERAL OBJECTIVE

9. MÉTODOS

10. POBLACIÓN
Características Total VSE VRE
Pacientes 58 35 23
Hombres 29 18 11
Mujeres 29 17 12
Edad 37 37 28
Leucemia 41 24 17
Linfoma 13 8 5
Otros 4 3 5
• INCan México

11. DEFINICIONES
NEUTROPENIA LINFOPENIA BACTERIEMIA
DEFECTO EN LA PRODUCCION,
MADURACION O
SUPERVIVENCIA DE LOS
NEUTROFILOS
CONTEO DE NEUTROFILOS
TOTAL <500/MM3
NEUTROPENIA GRAVE
<100/MM3
DESARROLLO FALLIDO DE UN
SUBTIPO DE LINFOCITOS O SU
DESTRUCCION COMPLETA
LINFOPENIA: <200/MM3
PRESENCIA DE BACTERIAS EN
SANGRE
DETECTADAS POR HEMOCULTIVO.
SE PRODUCE CUANDO LOS
MICROORGANISMOS INVADEN EL
TORRENTE SANGUÍNEO SE
MULTIPLICAN A UN RITMO
SEPTICEMIA, SEPSIS

12. BACTEC
9240
¿QUE ES?
FUNDAMENTO
¿PARA QUÉ?
Detecta el crecimiento
microbiano midiendo la
producción de CO2 por
colorimetría o por
fluorescencia
Se empleó para
identificar las
muestras de los
pacientes con E.
faecium
Sistema de hemocultivo que
permite la detección de
microorganismos en sangre.
Detección,
incubación y
agitación en una
sola unidad

13. PFGE
¿QUE ES?
Método de separación en el que se
utiliza una corriente eléctrica
pulsátil para dividir por PM y CE
moléculas.
Se basa en la separación de
moléculas de gran tamaño
(ADN), en función de la
dificultad que presentan
para moverse a través de
una matriz gelatinosa.
Se usó para separar
las diferentes cepas
de E faecium y
diferenciarlas en
resistentes o
sensibles.

14. ¿Qué es?
¿Cómo?
Aplicación
• Amplificación de un
gen, DNA o RNA in
vitro para obtener
millones de copias en
corto tiempo
• Desnaturalización
• Hidratación
• Replicación
• Identificar especies
y genes resistentes

16. RESULTADOS

18. FIG 2. Supervivencia: VRE punteada VSE continua

20. DISCUSSION

21. Author Quote Agree/desagree
Zaas AK, Song X, Tucker
P, Perl TM
Other authors reported vancomycin use, diabetes
mellitus, gastrointestinal procedures, and acute renal
failure as risk factors for VRE BSI in patients with cancer
who are colonized with vancomycin resistant
enterococci.
Hawkins CA, Collignon
P, Adams DN, Bowden
FJ, Cook MC
Patients with VRE experienced prolonged neutropenia
compared with controls
Vergis EN, Hayden MK,
Chow JW, Snydman DR,
Zervos MJ, Linden PK,
Stosor V, Peterson LR,
Postelnick
Although VREf has been identified as an independent
risk factor for mortality in patients with BSI
Gardete S, Tomasz A. The use of vancomycin selects VREf strains carrying
Tn1546. To explain the presence of this gene in VSEf
strains it can be postulated that VanA is present but not
functional because the VanA itself is mutated or some of
the other genes required for the vancomycin-resistance
phenotype—like VanR, VanS, VanX, VanY, or VanZ—are
absent in the transposon or mutated.

22. CONCLUSIONS

23. Pacients with
inmunodeficiency are more
propensive to E. faecium
infection
Efaecium is so persistance in
the organism, that it can
cause difficults when
developing therapy
mechanisms
The research did not find
genetic proximity between
strains of E. faecium
because these bacteria
developed resistance
through different
mechanisms
Antibiotic treatments should
not be used indiscriminately
because this causes large
variety of microorganisms
to become resistant, and
therefore a health hazard

24. MAPS