THE EMERGENCE OF ENTEROCOCCI AS A CAUSE OF NOSOCOMIAL INFECTION

Enterococci have traditionally been regarded as low-grade pathogens bu t have emerged as an increasingly important cause of nosocomial infect ion. The rise in hospital-acquired enterococcal infection has been in part due to the increased use of broad-spectrum antibiotics and the ri sing number of severely ill patients. The intrinsic resistance of ente rococci to many antimicrobial agents, and the acquisition of resistanc e to the few antibiotics available for treatment, has led to real ther apeutic difficulties. The microbiological laboratory has an important role to play in the control of enterococcal infection through surveill ance, and should be able to identify; antibiotic-resistant strains lik ely to cause a problem. Infection control measures, such as source iso lation of infected or colonised patients, should be considered. The po ssibility that vancomycin-resistant strains of enterococci are enterin g the community via the food chain indicates the need for gl eater con trol of the use of glycopeptide antibiotics in animal feed.