A New Era for Treating Enterococcus faecalis Endocarditis

Abstract

E nterococci are the third most common etiologic agent of infective endocarditis worldwide after staphylococci and streptococci and cause 10% to 15% of cases. 1 Enterococcal infections are increasingly relevant, especially among the elderly and patients with comorbid conditions in the health-care setting. 2,3 Approximately 90% of cases of enterococ-cal endocarditis are caused by Enterococcus faecalis, with <5% caused by E. faecium. 2,3 The morbidity and mortality of enterococcal endocarditis are high. The percentage of patients requiring cardiac surgery (42%) and the 1-year mortality rate (29%) have remained almost unchanged for the last 30 years; recent data show that they may even be increasing. 3