Research ArticleBACTERIAL INFECTIONS

Impact of antibiotic treatment and host innate immune pressure on enterococcal adaptation in the human bloodstream

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Science Translational Medicine  10 Apr 2019:
Vol. 11, Issue 487, eaat8418
DOI: 10.1126/scitranslmed.aat8418

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Friend turned foe

Enterococci are commensal bacteria found in the gut of most humans. Strains have arisen that are able to survive disinfection protocols in hospitals and that are resistant to antibiotics, resulting in the spread of this bacterium from patient to patient. To elucidate how enterococci have made this adaptation, Van Tyne et al. analyzed the genomes of enterococcal strains from an early outbreak of bloodstream infection in a hospital ward in the mid-1980s. They report the genetic changes that enabled the enterococci causing the human bloodstream infection to survive elimination by the host innate immune system and antibiotic therapy.