What is enterococcus spp. Bacterial infection of the genitourinary system

Enterococcus faecalis is a small oval bacillus that exists in the stronger sex with normal microflora in every organism. It is located in the intestines - on the shell of the genitourinary system. After taking antibiotics, when other bacilli are destroyed, the microorganism multiplies and takes their place. This leads to inflammatory processes in the urine, reduced potency, depression and weakness. At the beginning of the development of the infection, men may not notice such symptoms, but if they are detected at an early stage, then special treatment is not required - Enough to strengthen the immune system.

What provokes the development of bacteria?

Fecal enterococcus in the stronger sex, due to high immunity, may not manifest itself in any way, that is, the immune system can cope with it on its own. However, if, for certain reasons, health goes down, then the number of these bacteria increases dramatically, which is a danger to the body.

Reasons for the development of bacteria:

• avitaminosis;
• various diseases;
• weak immunity;
• chronic prostatitis.

Avitaminosis is a lack of nutrients in the body. Signs include lethargy, drowsiness, constant illness, irritability, poor appetite. It can be mistaken for a temporary breakdown, but this would be a mistake. In order to prevent such a cause of the appearance of enterococcus, it is necessary to constantly take various types of vitamins, monitor nutrition, play sports and exclude tea, coffee, alcohol and carbonated drinks.

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Improper nutrition causes serious disorders in the body and various diseases, including enterococcus. To avoid this, you need to follow the diet. Exclude harmful products. Do not eat on the go or in front of the TV. Most of the food should be fruits and vegetables.

When a person is sick, he uses medicines, including antibiotics. They lead to a violation of the microflora. And this is the main reason for the reproduction of fecal enterococcus by reducing other bacteria. The immune system weakens and the bacillus develops.

Immunity is the body's ability to fight infections. To increase it, you need to use special vitamins and minerals. This can be done through nutrition (fruits, dairy and seafood, green tea, proteins). An active lifestyle will also improve health. Another way is hardening (dousing, contrast shower).

Chronic prostatitis is one of the most common diseases of the genital organs. It occurs due to the genitourinary system not cured in time, which leads to the development of enterococcus. The first symptom is cutting or aching pain in the lower abdomen. Reduced duration of intercourse. Ultimately, pain is present with every urination.

Signs of the disease

Fecal enterococcus leads to various disorders in the reproductive system and on the intestinal mucosa. It all depends on where the bacillus is located. Guys, basically, suffer from inflammation of the genital organs. Over a long period of time, the symptoms are hidden, but under bad conditions become demonstrative.

On the initial stage enterococcus in men does not manifest itself in any way, but over time it becomes noticeable. Signs by which the disease can be identified:

• difficult urination;
• discomfort in the groin and in the urethra;
• erection problems;
• decline in potency;
• lethargy, weakness, fatigue;
• change in the color of urine;
• pain during bowel movements.

There are symptoms that are characteristic of a particular disease. Enterococcus in the prostate:

• pain in the testicles in men;
• burning sensation after sex;
• discomfort in the perineum;
• urination disorders;
• failure in orgasm;
• purulent discharge.

Enterococci in men in the urethra:

• diseases during urination;
• discharge;
• irritation in the urethra.

With balanitis, patients have complaints of pain, redness, swelling, discharge in the penis. With orchiepididymitis - for testicular inflammation, dull pain in the scrotum. If the disease is chronic, then there is the possibility of blood in the semen.

How does the pathogen enter the reproductive system?

There may be such causes of infection:

• improper hygiene;
• violation of the intestinal microflora;
• unprotected sexual contact;
• transmission from mother to child;
• organ transplant (rare).

Enterococcus fecalis affects the stronger sex, who neglect hygiene. For those who rarely shower, the bacillus attacks in the urethra and prostate. During water procedures, it is better to use a special soap or gel that kills microbes. So that they do not have a chance to develop, it is necessary to wash your hands after using the toilet.

The intestinal microflora is disturbed with prolonged use of antibiotics. Under their influence, the necessary bacteria die, and enterococci take their place. At this point, an inflammatory process develops. In addition, frequent changes in the body occur due to the change of sexual partners. The main representative can still be staphylococcus aureus.

When enterococci enter the genitals, they stay there for several hours or weeks. This condition is called "temporary carriage." A person transmits inflammation to his partner during sex. In this case, the disease can be detected only by high-precision methods.

The rarest case of infection with a harmful microorganism is an organ transplant. Thanks to this operation, the bacterium can pass from a sick donor to healthy person. This is mainly due to kidney transplantation, coronary artery bypass grafting (restoration of blood flow in the arteries of the heart), reconstructive operations (surgical intervention to restore the functions of the pelvic floor).

Analyzes

Infectionists are working on this disease, but a urologist and a venereologist should also be visited. To identify it, you need to pass tests:

• seeding of prostate secretion;
• general analysis of blood and urine
• smear from the anus and urethra.

Spermogram is the only method to detect the inability of a man to fertilize and the presence of infectious diseases (including fecal enterococci). Usually the results of this study are ready the next day. In urgent cases - after 3-5 hours. There are two ways to submit. The first is to collect the biomaterial at home and take it to the clinic, the second is to hand it over immediately to the laboratory. To pass the analysis correctly, the following rules must be observed:

• refrain from sexual intercourse for several days;
• give up alcohol, drugs, saunas and baths;
• avoid hypothermia;
• before research, take a shower, especially rinse the genitals well;
• donate sperm only in a sterile container;
• the collection is carried out by masturbation;
• place all biomaterial in a container without touching its walls.

To identify the source of infection in the secretion of the prostate, bakposev is taken. It is needed so that the doctor can prescribe effective treatment. The collection is carried out by massaging the prostate gland. The patient should relax and lie on their side with their knees bent. Juice is secreted, which is necessary to determine the sensitivity of the body to antibiotics.

Blood for analysis is taken on an empty stomach, preferably in the morning. Do not smoke for at least an hour before donating, and exclude alcohol. Urine is also given in the morning. You need to take a thorough shower. The day before, remove from the diet foods that can affect the color of urine.

Before taking a smear from the anus, it must be thoroughly washed with soap and water. Then the probe is inserted 2.5-4 cm deep and gently rotated for 10 seconds to obtain the desired material. It is introduced into the urethra to a depth of 1-1.5 cm, turning it several times. This procedure is carried out 2-3 hours after urination.

Diagnostics

For effective treatment diseases need to be diagnosed to determine how to cure enterococcus. To do this, it is advisable to go to the doctor and take tests, as well as undergo a study that determines sensitivity to antibiotics and a laboratory examination.

With negative results, it is not necessary that enterococcus is the cause of a particular problem. If the tests did not show the source of infection, then the diagnosis should be repeated. Only after the exclusion of other harmful bacilli is a course of treatment prescribed to eliminate the bacterium.

Treatment of the disease

Only after the enterococcus is detected and confirmed by the diagnosis, the urologist prescribes treatment. This is done because the bacillus can be found in a non-ill man and be normal. With a weak manifestation of the disease, one drug is enough, but if it turns out to be ineffective, then there is an option to supplement with another or several.

If the infection is mixed, a separate medication is selected for each pathogen. There are three rules for how to treat enterococcus in the stronger sex:

• antibacterial therapy - preparations of the bacteriophage group (viruses that feed on certain bacilli) are selected, which are used for a long time;
• medicines are used - gels, ointments, suppositories, they normalize the microflora and heal the mucous membrane of the genital organs;
• ways to increase immunity - taking vitamins that improve the body.

The specialist can still prescribe additional methods to reduce the risk of bacilli:

• folk remedies (drinking cranberry juice, baths from herbal infusions);
• massage course (rectal or hardware prostate gland of the same action);
• homeopathic preparations;
• vitamins;
• physiotherapy procedures.

If a person does not engage in treatment, then:

• the infection will spread to other organs;
• the disease becomes chronic;
• sperm quality will deteriorate.

It is impossible to ignore medical recommendations and self-medicate. This will lead to deterioration, not recovery. For example, if you get carried away with solutions from antiseptics (miramistin), you can get a burn of the mucous membrane. Such a provocation will increase the development of bacteria. Therefore, it is necessary to do everything that the specialist says. Enterococcal prostatitis can be treated in the same way.

Development prevention

Any disease can be prevented if precautions are taken. Prevention for enterococcus:

• compliance with the rules of safe sex;
• timely treatment of chronic and sexual diseases;
• right way of life;
• daily change of bed and underwear;
• proper storage and preparation of food;
• observe personal hygiene.

By following these rules, a man will reduce the risk of infection. In addition, he should remember that during the entire treatment it is impossible to have sexual intercourse. At the first sign, you should immediately contact a specialist.

Benefits of Enterococcus

This microorganism brings not only harm, but also benefit. But in the event that it does not overlap the male norm of acceptable indicators in the body. Faecalis in a male smear should not exceed 100 million per 1 gram of feces. Then it is even useful, especially for the genitourinary system.

The microorganism performs the following functions:

• helps sugar to be better absorbed;
• processes carbohydrates;
• improves immunity;
• destroys pathogenic microorganisms.

It is also used in food products, especially in the production of sour-milk ingredients. For example, when fermenting milk, hydrolyzing lactose, suppressing bacteria in food. It has great resistance to acids, salt and high temperatures.

Enterococci are lactobacilli that are considered conditionally harmful. This means that, within the established norm, their presence in the body women does not say that treatment is necessary. It is interesting to note that the higher the age of the fair sex, the higher the number of acceptable bacteria.

Normally, enterococci are found in the body of every person. When they become more than necessary, various diseases can develop. To prevent undesirable consequences, timely diagnosis and well-prescribed treatment.

Previously, enterococci were attributed to the group of staphylococci; these microorganisms began to be differentiated from the end of the 80s. The danger is that these bacteria can provoke the development of many infectious diseases. For this reason, you should be very careful about the sudden appearance of enterococci in a smear above the norm and do not postpone the consultation with a doctor and treatment.

Symptoms

If the number of enterococci is greatly increased, then this usually noticeably affects the woman's health.

Here are some symptoms of a developing disease:

• cloudy urine;
• copious discharge, which may be light at first;
• at chronic form discharge diseases take on a greenish color, can become cheesy;
• itching appears in the vagina;
• there is no desire for intimate communication due to the discomfort experienced;
• there may be pain in the lower abdomen.

Most often, enterococci affect the urinary-genital system, since there are all conditions for their reproduction. That is why it is worth constantly monitoring your analyzes.

Methods of infection

Consider the main ways in which the described disease is acquired:

• not thorough enough genital hygiene;
• sexual contact with a sick person;
• contact with personal hygiene items of the sick person;
• contact with non-sterile instruments and materials (in a medical hospital or other medical facility).

Treatment

Treatment of an increase in the rate of enterococci in a smear involves first carefully checking the diagnosis and conducting a study on the reaction of bacteria in relation to a particular antibiotic.

In milder infections use bacteriophages. Phytotherapy can also be successfully used as a concomitant to the main treatment. In some cases, the effectiveness of the latter may be sufficient without the use of other drugs.

With success in the described diagnosis are used immunomodulatory drugs. They can be taken topically (available in the form of suppositories). In addition to these drugs, it is important for a woman to lead a certain lifestyle during the treatment period. In particular, we are talking about how to exclude re-infection from a sick person, as well as an attentive attitude to improving immunity.

In general, the fight against enterococci can be quite lengthy, since these microorganisms are very stable and can develop even in the external environment.

During pregnancy

During childbearing female body often encounters development various diseases due to reduced immunity. The appearance of enterococci in the smear above the permissible limit indicates the development of some kind of inflammatory process of the genitourinary system.

In addition to the prospect of getting completely unwanted pyelonephritis, the threat is that the pathogenic microflora can adversely affect the development of the child.

Many doctors associate the development of various diseases in the baby even inside the womb with an increase in enterococci in the genitourinary system, and bacteriuria can also threaten miscarriage or premature rupture of amniotic fluid. In this regard, treat such a diagnosis expectant mother is very responsible.

Therapy during pregnancy, as a rule, includes taking vitamin-mineral complexes allowed for this period, douching and, if the case so requires, antibacterial drugs (an antibiotic may be prescribed).

Prevention

Preventive measures often include personal hygiene. It is necessary to take a shower twice a day with a thorough washing of the genitals. It is unacceptable to use other people's hygiene items and underwear.

If an increase in enterococci is found in the second half, then one should refrain from intimate intercourse for the period of treatment, or use contraceptives. We must not forget to wash our hands before eating and after street walks.

In order not to get sick, you should pay attention to the fact that the body does not experience hypovitaminosis. Not always synthetically produced vitamins are perceived by the body. Therefore, you need to monitor your own diet. Lifestyle, which leads a woman, also greatly affects the state of her health and the potential vulnerability of the body.

It is good not to neglect walks in the fresh air, even better if such events become regular. Physical education will also help keep yourself in shape and prevent the body from relaxing before the onslaught of infections and other threats.

You should not, having seen enterococci in a smear, immediately worry. First, make sure that the indicators are above the norm. Before starting treatment, you can repeat the analysis, since the result of the first study may be incorrect. If the presence of the disease is confirmed, you can not self-medicate, especially for pregnant women.

Remember that aggressive treatment is not always required with an increase in enterococci in a smear; in some cases, the appointment of preventive measures along with taking vitamin complexes(sometimes immunostimulants are added) allows you to recover quickly and effectively.

Enterococcus fecalis- This is a conditionally pathogenic microorganism that is present in all representatives of mankind without exception. Enterococcus lives on the mucous membranes of the oral cavity, in the intestines, and partly in the genitourinary structures.

With adequate functioning of the immune system, enterococci perform important physiological functions, assisting in digestion and fecal formation. When the defense system is weakened, the microorganism makes itself felt with a mass of symptoms.

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In most cases, enterococci can be detected: this is a normal physiological phenomenon. Much depends on the number of pathogenic microorganisms. The more of them, the higher the likelihood that immunity fails.

The picture becomes obvious when the specified organism is found in. This means that the microflora has multiplied to such an extent that it has already penetrated higher, along the ascending path. It can start at any moment or it has already started. Additional studies are required to clarify the nature and type of process.

Clinical manifestations

Clinical signs of damage to enterococcus are numerous. In most cases, the acute period makes itself felt with the following characteristic phenomena:

All of these manifestations may occur. Maybe just a part.

Is asymptomatic carriage possible?

Since enterococcus belongs to the opportunistic flora, asymptomatic carriage is not only possible, it is likely, since the indicated microorganism occurs in all people without exception. Another thing is that it is possible to reduce the effectiveness of the immune system, in which case the carriage will result in unpleasant consequences for the patient.

The danger of infection with enterococcus fecalis

The microorganism is of considerable danger for a number of reasons. Therefore, the lack of treatment is fraught with adverse consequences for the patient's body:

• Enterococcus is characterized by considerable vitality. He is not afraid of critical temperature changes.
• The second significant factor is the resistance of microorganisms to many antibacterial drugs.
• Enterococci are not afraid of the lack of oxygen.
• They easily multiply with fermentative dyspepsia.

Therefore, a careful approach to diagnosis and treatment is required.

Complications

In the absence of competent treatment, the defeat of the described microorganism is fraught with the following consequences:

• prostatitis;
• urethritis;
• purulent-inflammatory diseases of the pelvic organs;
• sepsis.

Possible development of serious consequences for life and health.

Diagnostics

Diagnosis of enterococcal infection is carried out by infectious disease doctors. In addition to routine tests, questioning and examination, bacteriological inoculation of biomaterial on nutrient media is used. It makes it possible to sow the pathogen, as well as to determine its sensitivity to antibiotics.

Treatment

Fecal enterococci are microorganisms that help maintain an optimal acid-base balance inside our intestines, are involved in the production of vitamins, and 1/3, together with other microbes, they make up the mass of our feces. Therefore, it is illogical to indiscriminately destroy enterococcus, since normally it will still be useful to us. It is necessary to use only those means that can lead to the destruction of the urogenital localization of the pathogen, and not affect its intestinal form.

Of course, it is impossible to do this completely: after all, antibiotics destroy microbes anywhere in the body. What happens if you don't use antibiotics? Is it possible to do without them? Yes, you can. To do this, you need to use a specific enterococcal bacteriophage. Bacteriophages are viruses that feed on a specific type of microorganism. In particular, enterococcal bacteriophage is active, in addition to these cocci, also to Escherichia coli, Salmonella, Shigella, as well as to Proteus, and many other microorganisms.

Men with urogenital enterococcosis should install a bacteriophage solution into the urethra, wash the glans penis and the inner layer of the foreskin with it. This will allow viruses to locally destroy the population of bacteriophages brought from the intestine. Since microorganisms are most often introduced from the rectum, the bacteriophage is also used rectally to prevent such “self-infections”. The course of treatment with a bacteriophage is 7-10 days, one dose for rectal administration is 50 ml of the drug in the form of an enema, which must be given after a bowel movement. Produced "Intesti - bacteriophage" in vials, 100 ml.

In addition, recommended topical application of creams and ointments containing antibacterial drugs, and allowing to disinfect the mucous membrane of the genital tract. So, it can be successfully used: a solution of chlorhexidine, furacilin and miramistin, according to the instructions.

The use of a bacteriophage instead of antibiotics ensures that the populations of healthy and desirable microorganisms in the gut remain healthy and the gut dysbiosis that often accompanies any antibiotic treatment does not develop.

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Enterococci are bacteria related to. They live in the gastrointestinal tract, organs of the genitourinary system, and are sometimes found in the oral cavity. They perform important functions: participate in digestion, contribute to strengthening immune protection and other. But under the influence of certain factors cause diseases.

The main feature of enterococci is that they belong to. About 20 species have been identified:

Some of them are part of the microflora, an essential component of food products. They promote lactic acid fermentation. They are used in Food Industry for the manufacture of hard cheeses and cottage cheese.

In the human body, enterococci of the species mainly live:

• fecalis;
• facium.

These strains of enterococci, together with other aerobic cocci, account for 25% of the entire parietal microflora of the small intestine and 5–6% of the microflora of the large intestine.

They are necessary because:

• participate in the synthesis of vitamins;
• break down complex carbohydrates;
• do not allow other pathogenic microorganisms to multiply;
• enhance immunity.

Enterococci are part of probiotics - medicines that normalize the intestinal microflora:

• Linex;
• Symbioflor.

For the manufacture of medicines and food products, the least pathogenic strains of enterococci are used.

At the same time, it is precisely those strains that live in the intestines (enterococci fecalis and faecium) that are the most pathogenic for humans. With the intensive growth of colonies, purulent-inflammatory diseases occur. They are the main cause of hospital infections. At the same time, their treatment is difficult: enterococci are resistant to the effects of gastric and intestinal juice, and show resistance to most antibiotics. Their number decreases with a decrease in the acidity of gastric juice.

If in environment, especially on food products, these types of enterococci accumulate, the risk of exogenous infection increases. Therefore, food industry workers undergo a special medical commission. If an increased content of enterococci is detected, they are not allowed to work.

Why are enterococci dangerous?

Although enterococci are representatives of the normal microflora, they have a share of pathogenicity. At intensive reproduction enterococci, they cause endogenous infection. With the flow of blood, lymph, they enter other organs, causing:

When enterococci enter the abdominal cavity, a spontaneous bacterial infection occurs, which can be fatal.

Enterococci, in addition to synthesizing vitamins and promoting digestion, secrete toxins - endogenous neurotransmitters (ammonia, mercaptan). Thus, they become the main reason for development. The disease develops rapidly and leads to severe complications:

• infectious-toxic shock;
• vascular thrombosis;
• endocarditis;
• pyelocystitis.

The liver suffers from exposure to toxins: it does not have time to neutralize the harmful substances produced by bacteria. cirrhosis occurs. Then the metabolites enter the bloodstream and cause a picture of hepatic encephalopathy.

If the enterococci themselves penetrate the blood vessels, a severe and very dangerous condition occurs - sepsis.

Excessive colonial growth of bacteria leads to an imbalance in the normal intestinal microflora. Developing.

Enterococci are the causative agents of diseases of the genitourinary system. Most often called:

• cystitis;
• prostatitis.

Often inflammation of the bladder becomes the cause of the development of pyelonephritis.

Risk factors

Diseases caused by enterococci occur under the influence of two main factors:

• decrease in the immune defense of the body;
• ingestion of pathogenic strains with food.

The presence of enterococci in drinking water and food products is the main criterion for fecal contamination.

How and where are enterococci found?

A study on the content of enterococci is carried out with infectious diseases, intestinal dysbacteriosis. Most clinical laboratories use:

• PCR diagnostics;
• chromato-mass spectrometry;
• study of microbial metabolites.

For tests, they take feces, smears, urine, depending on the disease. Sowing on different nutrient media is carried out. Since enterococci are similar to streptococci (they did not differentiate until the mid-80s), they use the following properties of enterococci:

• inertness to bile salts;
• the ability to grow in the presence of 6.5% hydrochloric acid;
• the ability to decolorize milk with litmus or methylene blue (a sign of lactic acid fermentation).

Examination of feces

Basically, such studies are carried out with intestinal dysbacteriosis or for differential diagnosis with various inflammatory processes in the gastrointestinal tract.

For analysis, the material is collected in a sterile container. It is taken from different places in the stool, be sure to collect mucous, purulent or bloody inclusions (if any). Bacteriological examination must begin no later than 1 hour after sampling.

Normally, in the feces of enterococci there should be:

• children under 1 year - 10 5 -10 7 colony-forming units / g (CFU / g);
• from 1 year to 60 years - 10 5 -10 8 CFU / g;
• over 60 years old - 10 6 -10 7 CFU / g.

In the study, be sure to pay attention to the percentage of enterococci in comparison with other representatives of the normal microflora. Normally should prevail.

Urinalysis

Urine is examined for the content of enterococci in inflammatory diseases of the genitourinary system. It is normally sterile. Bacteria enter the urine from the distal urethra. Since urine contains carbohydrates, salts, urea, urine is an excellent nutrient medium in which bacteria multiply rapidly.

For correct diagnosis, it is necessary to prevent bacteria that colonize the external genitalia from entering the urine. For this:

If no more than 10 4 bacteria are detected in urine, the study should be repeated after a while.

To differentiate the causative agent of the disease, a bacteriological study is carried out.

Smear examination

Enterococci live not only in the intestines. They are representatives of the normal microflora of the vagina, external genitalia. In case of non-venereal infectious diseases in women, smears from the vagina, cervix, uterus, vulva, and urethra are examined.

Since most pathogens die in the external environment, studies should be carried out immediately after sampling or the use of preservative liquids.

Symptoms

The clinical picture of infection depends on which organ is affected by pathogenic strains of enterococci.

General

The disease proceeds like any infectious disease, manifesting itself:

• an increase in body temperature;
• nausea;
• dizziness;
• weakness.

Specific

• When defeated respiratory system- cough, runny nose, sore throat, chest.
• With infection of the genitourinary system - painful urination, frequent false urges,.
• Dysbacteriosis is characterized by diarrhea, flatulence.
• With food poisoning, they are accompanied by vomiting.

Endogenous sepsis is especially dangerous. The disease proceeds with short-term rises in body temperature, chills. If it is fulminant, then septic shock develops rapidly. Death occurs within 1-2 days.

The pain may last for months. Occasionally, the patient complains of subfebrile body temperature, dizziness. The temperature rises for no reason (no cough, pain, runny nose). And in the end, serious complications can occur, including death.

To prevent the progression of the disease, you must consult a doctor. He will prescribe an appropriate examination and select the optimal treatment tactics.

Treatment

Since enterococci constantly live in the intestines, and antibiotics are used to treat any infectious diseases, these microorganisms have acquired resistance to these types of drugs. They are difficult to treat with cephalosporins, oxolinic acid, fluoroquinolones, chloramphenicol.

With enterococcal lesions, therapy is carried out:

• ampicillin with gentamicin;
• mezlocillin with amikacin.

For treatment, it is preferable to use those containing lacto- and bifidobacteria, non-pathogenic strains of enterococci, Escherichia coli:

Diseases caused by enterococci are difficult to treat. Everything is complicated by the fact that these microorganisms are permanent inhabitants of the intestine. They are part of the normal microflora that perform a number of important functions. Therefore, the development of the disease is better to prevent.

Prevention

There are no specific methods for the prevention of enterococcal infection. Vaccines have not been created. But the disease can be prevented. For this you need:

1. Adhere to basic hygiene rules.
2. Eat properly. The growth of non-pathogenic microflora is promoted by lactic acid products.
3. Boost immunity. Endogenous infections cause pathologies with a reduced protective reaction of the body. And increase immunity by hardening, the use of vitamins and minerals. There are also drugs that enhance immune defenses.

And most importantly, never self-medicate, especially with the use of antibiotics that inhibit the normal microflora and contribute to the development of pathogenic strains of microorganisms. If symptoms of an infectious disease appear, you should consult a doctor who will select a treatment regimen depending on the pathology and the pathogen that caused it.

Previously enterococci not isolated separately, but attributed to the group of class D streptococci, but according to modern classifications they were singled out separately.

These microbes belong to the group of gram-positive microbes, there are about 15 species of them today, although they are not yet well studied and classified.

To the main ones that doctors turn to Special attention, include enterococcus faecalis (fecal enterococcus) and enterococcus faecium (enterococcus faecium). Enterococci are the most important representatives of the human microflora and can affect life, both positively and negatively.

About the microorganism

Enterococci are small, round-shaped microbes that do not form capsules and spores; they can live in the absence of oxygen in the body, or in an oxygen environment. Therefore, they are widespread and quite resistant to environmental factors. Microbes can grow at positive temperatures, but the most optimal for them are 37-39 degrees, that is, the temperature inside the body. Enterococcus can persist in the external environment for a long time, is resistant to disinfectants and can live on various surfaces in the house, it withstands boiling and heating well.

Enterococci are quite common pathogens of various diseases - for example, they are often responsible for the development of urinary and genital tract infections, infections inside abdominal cavity, lesions of the pelvic organs, and can also cause a complication of wound processes, heart damage with the formation of endocarditis. Enterococcus accounts for up to 10% of all nosocomial infections, especially in relation to the urinary tract, wound processes and general septic processes.

However, in parallel with this, enterococci are integral part normal human microflora gastrointestinal tract, can play an important role in the formation of protective properties in the mucous membranes of the small and large intestines and the formation of intestinal immunity. Enterococci mainly live in the small intestine, although a significant number of them also live in the large intestine. Enterococci are also found in the area of ​​the urethra in men and women, children, in the genital area, as well as on the mucous membranes of the oral cavity.

Clinical materials from all possible areas of the human body contain the vast majority of fecal enterococcus, and the remaining part is Enterococcus fascium. All other enterococci are in no way related to variants of the normal intestinal microflora and can be either alien and non-pathogenic, or dangerous in terms of health.

If we determine the number of enterococci in the intestines, then on average they make up about 1% of the total volume of microflora, that is, they are more than a hundred times less than bifidoflora and lactoflora; in children, the norm of enterococcus is its amount in one gram of feces - 10 per 6-10 to the 7th power. The colonization of the intestines by these microbes occurs in children in the first hours of life, at the first attachment of the child to the breast; in artificial workers, the process of colonization of the microbial flora of the intestine is more difficult and longer, since they receive microbes from objects, air and hands of personnel.

If we consider pathogenic properties enterococci - then some of its strains can cause urinary tract infections in children and adults, especially if before that patients took a large amount of antibiotics, drugs that suppress the immune system, or were subjected to various invasive examination methods.

The most pathogenic for children are:

1. enterococcus faecalis (fecal enterococcus),
2. enterococcus faecium (enterococcus fecium),
3. enterococcus durans.

Predisposing factors for the development of enterococcal infection are infancy or old age, severe infections of the child, hypoxia in childbirth, immunosuppressive conditions, violation of the integrity of the skin and mucous membranes, violation of the normal microbial flora of the intestine due to various diseases and metabolic disorders. In connection with the widespread and not always indicated use of antibiotics, in the last ten years there has been a tendency towards an increase in the number of pathogenic forms of enterococcus. Resistant to the main, widely used antibiotics, which greatly complicates the treatment of resulting enterococcal infections.

Enterococci in medicine

It would be completely unfair to say that enterococci are either neutral or harmful microbes. This is far from being the case; it is actively used in various industries and medicine, bringing a lot of benefits to a person. Enterococci are actively used in the synthesis, manufacture and composition of many drugs, they are part of many biologically active additives and biological preparations.

So - enterococci are added as active ingredients of some drugs (probiotics), which are used to correct the microbial flora of the intestine and treat everyone's favorite "dysbacteriosis", restore normal intestinal microflora. So, enterococci are part of the well-known preparations of bifiform, linex, they contain a non-pathogenic and very antibiotic-resistant strain of fecal enterococcus, which displaces pathogenic forms of other microbes from the intestine, allowing the growth of normal microflora. Also, fecal enterococcus is part of the well-known drug against indigestion and diarrhea - hilak-forte, again due to the ability to suppress the growth of pathogenic forms of microorganisms.

Initially non-pathogenic, artificially derived strains of enterococci, which are intended for use in the food and medical industries, are added to medications. These microbes are intended for a short stay inside the human body without causing any harm to it. After one to two weeks, these forms of enterococcus completely leave the human body.

According to Sanpin 2.3.2.2340-08, approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated February 18, 2008 No. 13, the use of enterococcus durans and enterococcus faecium in food production is completely allowed.

The use of enterococci in the food industry

The use of fecal enterococci in the food industry has long been debugged, they are used as special starter cultures due to the ability of enterococcus to break down milk sugar (lactose), which leads to fermentation and souring of milk. In addition, enterococci actively inhibit the growth of pathogenic microorganisms in milk, while the enterococci themselves are quite resistant to the action of organic acids of products, salt and high temperatures.

Enterococci are widely used in the preparation of cheeses, and depending on the strains, cheeses are obtained in different flavors. So, with the help of Enterococcus, Camembert cheese is produced, and some others in the production of cottage cheese.

Pathogenic strains

Enterococci can show their pathogenicity in places that are not typical for their stay. So, they can be dangerous when penetrating into the urinary tract of their area of ​​​​the rectum, especially if they penetrate into the ascending bladder or kidneys. Sometimes there is a state of asymptomatic bacteriuria (the presence of microbes in the urine without signs of infection). An increase in the number of microbes in the urine above 10 to the 5th degree in one milliliter of an average portion of urine should cause concern. In all other cases, we can talk about defects in the collection and contamination of urine with secretions from the genital tract and containers.

If the urine is taken by a catheter or there are manifestations of an infection, then any amount of a microbe can be diagnostic. The presence of microbes in the urine of children and pregnant women is especially important, since their immunity is physiologically reduced. In addition to asymptomatic bacteriuria, there may be options for the development of cystitis, pyelonephritis, urethritis, or prostatitis. If the presence of only germs in the urine does not always require immediate treatment. That is, the presence of a clinic is a signal for the immediate start of therapy.

The main culprit for infections of the urinary system is fecal enterococcus, other forms in the genitourinary tract are not found. This condition is usually treated with antibiotics, which have urotropism depending on the age and condition of the body.

Enterococci can be part of the normal microflora of the vagina, but normally there are a small number of them there, no more than a tenth of a percent. Usually, an increase in the number of enterococcus in a smear indicates a violation of intimate hygiene and is accompanied by the development of a clinic of vulvitis or vulvovaginitis, especially in young girls.

Fecal analysis

Often, enterococci are detected in the analysis of feces for microflora (analysis for dysbacteriosis).

Normal in children:

1. up to a year, the number of enterococci is from 10 to 5 to 10 to 7 degrees per gram of feces,
2. for children from a year old, this norm is from 10 to 6 to 10 to 7 degrees.

At the same time, the vast majority of enterococci are fecal forms.

Methods of treatment of pathogenic forms of enterococcus

If an overgrowth of enterococcus is found, there is a special recommendation for this case. Intestinal dysbacteriosis.

According to this order, with the pathogenic growth of enterococcus, the use of bacteriophages is indicated - intesti-bacteriophage, liquid, taken several times a day on an empty stomach. It is used for children from birth, but diluted with water, it is also possible to use bacteriophages in enemas. At the same time, the activity of bacteriophages against enterococci is lower than when antibiotics are used, but given the high resistance of enterococci to antibiotics, bacteriophages are safer, they have no contraindications and fewer side effects.