Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Enterococcus faecalis / faecium — Enterococcus

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 30 October 2026 · Methodology

Enterococcaceae · Gram-positive

EI fréquente au cours des bactériémies à entérocoque, surtout E. faecalis. ETT/ETO recommandée (ESC 2023). Traitement EI à E. faecalis : ampicilline + ceftriaxone (Fernández-Hidalgo 2013, cohorte observationnelle non randomisée de 246 patients — aussi efficace qu'ampicilline + gentamicine, arrêts pour effets indésirables 1 % contre 25 %, sans insuffisance rénale nouvelle) — association absente des lignes de traitement de la fiche (not verified) ou ampicilline + gentamicine si HLGR absent. E. faecium : généralement résistant à l'ampicilline — vancomycine en alternative. ERV (Entérocoque Résistant à la Vancomycine) : E. faecium résistant aux glycopeptides (gènes vanA ou vanB) = bactérie hautement résistante émergente (BHRe) ; le HCSP 2019 recommande son signalement au titre des infections associées aux soins (outil e-SIN) et des mesures spécifiques de maîtrise de la diffusion. Options ERV : linézolide, daptomycine.

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Enterococcus faecalis / faecium are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Heart / Endocardium	Moderate tropism	Evidence B	3	not recorded
Urinary system / Bladder	High tropism	Evidence B	2	not recorded
Colon / Alimentary system	Moderate tropism	Evidence B	2	not recorded
Skin	Rare tropism	Evidence B	1	not recorded
Prostate	Moderate tropism	Evidence B	2	direct
Meninges (post-neurochirurgie)	Rare tropism	Evidence B	1	direct

Described portals of entry

• Urinary system / Bladder
• Colon / Alimentary system

Spread routes recorded: 2 of 6 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Associated syndromes

• Infective endocarditis (IE)
• Urinary tract infection (UTI) (cystitis / pyelonephritis)
• Prosthesis-related infection
• Cholecystitis and cholangitis
• Bacterial peritonitis

Sources

• ESC Guidelines for the management of endocarditis (Delgado V et al.) (2023) — doi:10.1093/eurheartj/ehad193
• Fernández-Hidalgo N et al. — Ampicillin plus ceftriaxone for Enterococcus faecalis infective endocarditis (2013) — doi:10.1093/cid/cit052
• Murdoch DR et al. — Clinical presentation, etiology and outcome of infective endocarditis (ICE-PCS) (2009) — doi:10.1001/archinternmed.2008.603
• SPILF — Diagnostic et antibiothérapie des infections urinaires bactériennes communautaires de l'adulte (actualisation 2015) (2015) — https://www.infectiologie.com/UserFiles/File/spilf/recos/infections-urinaires-spilf.pdf
• IDSA UTI Practice Guidelines (2011) — doi:10.1093/cid/ciq257
• IDSA — Intra-abdominal Infections Guidelines (2010) — doi:10.1086/649554
• Mazuski JE et al. — The Surgical Infection Society Revised Guidelines on the Management of Intra-Abdominal Infection (Surg Infect) (2017) — doi:10.1089/sur.2016.261
• Lipsky BA et al. — IDSA Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections (CID) (2012) — doi:10.1093/cid/cis346
• Wagenlehner FME et al. — Epidemiology, definition and treatment of complicated urinary tract infections (2020) — doi:10.1038/s41585-020-0362-4
• SPILF — Infections urinaires masculines : antibiothérapie, recommandation SPILF 2026 (Info-antibio n° 109, juin 2026, version provisoire) (2026) — https://www.infectiologie.com/UserFiles/File/spilf/atb/info-antibio/info-antibio-2026-06-ium.pdf
• Tunkel AR et al. — IDSA Management of Healthcare-Associated Ventriculitis (CID) (2017) — doi:10.1093/cid/ciw861

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