Treatment and prevention of enterococcal infections--alternative and experimental approaches

Expert Opin Biol Ther. 2004 Sep;4(9):1519-31. doi: 10.1517/14712598.4.9.1519.


Enterococci are one of the leading types of organisms isolated from infections of hospitalised patients and the third most common cause of nosocomial bloodstream infections. They contribute significantly to patient mortality and morbidity, as well as healthcare costs. The emergence of resistance against virtually all clinically available antibiotics and the ability to transfer these resistance determinants to other pathogens demonstrates the urgency for an improved understanding of enterococcal virulence mechanisms, and the development of alternative treatment and prevention options. This article reviews new antimicrobials, vaccine targets, bacteriophage therapy, as well as treatments targeting virulence factors and biofilm, for their potential to treat and/or prevent enterococcal infections. Although clinical isolates often cause serious infections, so-called 'non-pathogenic' strains are used as therapeutics in the form of probiotics. Understanding the differences between true pathogens and beneficial commensals may help to evaluate future treatment and prophylactic options.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Antigens, Bacterial / immunology
  • Bacterial Vaccines / immunology
  • Bacteriophages / physiology
  • Biofilms
  • Biological Therapy
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Cross Infection / therapy
  • Drug Resistance
  • Enterococcus* / drug effects
  • Enterococcus* / immunology
  • Enterococcus* / pathogenicity
  • Enterococcus* / virology
  • Female
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / physiopathology
  • Gram-Positive Bacterial Infections / prevention & control
  • Gram-Positive Bacterial Infections / therapy*
  • Gram-Positive Bacterial Infections / transmission
  • Humans
  • Male
  • Probiotics / therapeutic use
  • Vaccination


  • Anti-Bacterial Agents
  • Antigens, Bacterial
  • Bacterial Vaccines