Ivy Mnemonics Home›Microbiology›Bacteria›Gram-Positive Cocci

Enterococcus faecium & faecalis

Gram ⊕Gram-positive cocci in chains/pairs

Enterococcus (faecalis/faecium)

Gut bug: bile-esculin +, grows in 6.5% NaCl, hardy — UTIs, biliary, and VRE.

🎬 The Hardy Gut Survivor
Tough enough to live in bile and salt
Scene illustration coming soon.
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Gut flora

Normal colonic flora (entero = intestine). Group D streptococci.

🔗 Lives in the gut.

🔬 Identification

  • •GPC in pairs/chains, catalase –.
  • •Group D; bile-esculin POSITIVE.
  • •Grows in 6.5% NaCl (Enterococcus) — non-enterococcal group D does NOT.
  • •Variable hemolysis (usually γ/non-hemolytic).

🦠 Disease

  • •UTIs (especially catheter-associated).
  • •Biliary tract infections.
  • •Subacute endocarditis after GI/GU procedures.

⚠️ Resistance (VRE)

  • •Vancomycin-resistant enterococci (E. faecium > faecalis) — vanA alters peptidoglycan to D-ala-D-lac.
  • •Treat VRE with linezolid or daptomycin.

🧠 Mnemonics

Entero = Enter the gutNormal gut flora that seeds UTIs, biliary tract, and endocarditis after instrumentation.
Bile + Salt tolerant = EnterococcusBile-esculin + AND 6.5% NaCl growth = Enterococcus (salt growth excludes S. gallolyticus).

🩺 Classic boards tip-off

Subacute endocarditis after a colonoscopy or GU procedure → Enterococcus. Hospitalized patient with vancomycin-resistant GPC → VRE.

Lesson Info

Duration
4 minutes
Status
Completed

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