Standard Precautions
Ampicillin-Sensitive
Ampicillin-resistant, Vancomycin-sensitive
VRE
Add gentamicin or streptomycin when cidal activity is required (eg for endocarditis) and agents are susceptible for synergy
Ampicillin-Sensitive
Ampicillin-resistant, Vancomycin-sensitive
VRE
Add gentamicin or streptomycin when cidal activity is required (eg for endocarditis) and agents are susceptible for synergy
Gram positive cocci in short chains
Nosocomial (esp. VRE), associated with prior antibiotics
Colonization
More likely to cause true infection in immunocompromised or after selection pressure from antimicrobial administration has eliminated other organisms
Bacteremia, endocarditis (usually subacute), intra-abdominal or hepatobiliary infection, UTI
Most E. faecium will be VRE