Enterococcus

The old dog with a new trick, if we go back to that, what it means is that Enterococcus secorum always could have caused sepsis.

But it's important to remember this started around 2000.

That's when they first started seeing it.

So welcome back.

It's great to be back.

So I love the title that you gave this, Enterococcus secorum, sepsis in young broilers and old dog with a new trick.

I love that.

I can't take credit for that.

And it gets more concerning.

Sugary foods and drinks during antibiotic treatment were also linked to blooms of a bacterium known as Enterococcus.

And some strains of intercoxas are drug-resistant, and they are associated with hard-to-treat infections, which mean longer hospital stays and a higher risk of death in vulnerable patients.

And let me go ahead and share with you what the lead microbiologist, Jonas Schulter, of NYU's Lane 1 Health, and this is how he described it.

The bacteria begin to replicate at an exponential rate.

And based on the cultures drawn later, this patient had E. coli, Klebsiella, and Enterococcus, classic aggressive gut flora, multiplying in its bile ducts.

So the immune system recognizes the invasion and launches an inflammatory attack, sending massive amounts of blood flow and white blood cells to the area.

Which causes the gallbladder walls to swell with fluid.

Well, our Newport chapter of Surfrider Foundation has a program called our Blue Water Task Force program, and that program specifically tests for the water quality at popular recreational beaches.

That program is looking at a bacteria called Enterococcus, and sometimes we look at E. coli as well.

These are both indicators of whether or not the water is safe to get in, or potentially you may be compromised with health issues.

So surfers and recreational users that frequent our beaches often love the little creeks and outfalls that stream out as much as they love the ocean.

Yeah, so definitely I think these are my thoughts, like trying to connect the two things.

Gram-positive can be Staphylococcus aureus, Enterococcus.

Raul, what are your thoughts?

yeah deborah i mean i did not consider enterococcus in my gram positive but definitely we have to consider that enterococcus as you said it's more of gi and gu and mark gave us the history of some incidental findings i just labeled as incidental findings so maybe i'm gonna i don't know if there is any correlation between that organism coming from the gu source causing uh this degree of inflammation i'm gonna talk to my urology colleagues and see if they can help us with any cystoscopy and doing any biopsy if that is the possible source of the underlying inflammation leading to the bacteremia or do you mark teachers

And so we give the same antibiotic over and over again, and if it doesn't work, we give it longer, right? But what we don't do typically is test to see what bacteria is there.

And what I know from all the doctors that we work with is that frequently, gut bacterias show up in the vaginal microbiome, things like Enterococcus, E. coli, strep, things that you wouldn't anticipate seeing there but can create chronic long-term problems, and metronidazole's not gonna touch it.

You can do it over and over again, and you're still not gonna get the result because you're not giving the right antibiotic.

So things like that, like, are happening to women pretty much every day.

So two, three key things have to happen.

One is that you have to keep the pH low, 'cause toxic bacteria likes to be in high pH.

So if the pH is high, above five, six, seven, then you're gonna have toxic bacteria there, whether it's Prevotella or Gardnerella or strep or Enterococcus or whatever the bacteria is.

That's the environment they need.

The most common causative organism is Escherichia coli accounting for around 70-80% of community-acquired UTIs.

Other organisms include Staphylococcus saprophyticus, the second most common in young sexually active women Klebsiella, Proteus, which is associated with urease production, and Staghorn calculi and Enterococcus species.

Female sex due to the shorter urethra allowing easier bacterial ascent.

Sexual intercourse sometimes called honeymoon cystitis.

So that's what the first test tests for.

The direct stool sample test, the swab culture tests, tests for E. coli, Klebsiella, Vibrio cholerae, Citrobacter, Proteus, Campylobacter, Clostridium, um, Enterobacter, Enterococcus, Streptococcus, Coagulas- uh, and, and so on.

So we have two sets of, of pathogenic organisms, each has its own separate test for, and our combined test, uh, covers the full spectrum of anything that is possibly be in your intestine.

This way, we're not missing anything.

So for instance, many bacteria are frequently coming from the rectum through the gut and making their way into the vaginal microbiome, which doesn't usually get tested.

So even things like Enterococcus or E. coli or strep is not infrequently found in the vagina, in the vaginal microbiome, and that's never gonna respond to metronidazole.

It doesn't matter how long you give it to somebody.

And ureaplasma is another one that's quite ubiquitous, right? That men don't feel it when they have it, and so they spread it, and it's a really difficult bacteria to kill because it's really hides in the folds of the urethra, both in men and women.

And VRE?

VRE is vancomycin-resistant Enterococcus.

Enterococci normally live in our intestines and genital tract without causing problems, but if they enter the blood or urinary tract, they cause severe infections.

And this strain has become resistant to vancomycin, which is often considered an antibiotic of last resort.