Early in its evolution, Enterococcus faecium acquired traits that allowed it to become a successful nosocomial pathogen. E. faecium inherent tenacity to build resistance to antibiotics and environmental stressors that allows the species to thrive in hospital environments. The continual wide use of antibiotics in medicine has been an important driver in the evolution of E. faecium becoming a highly proficient hospital pathogen. For successful prevention and reduction of nosocomial infections with vancomycin resistant E. faecium (VREfm), it is essential to focus on reducing VREfm carriage and spread. The aim of this review is to incorporate microbiological insights of E. faecium into practical infection control recommendations, to reduce the spread of hospital-acquired VREfm (carriage and infections). The spread of VREfm can be controlled by intensified cleaning procedures, antibiotic stewardship, rapid screening of VREfm carriage focused on high-risk populations, and identification of transmission routes through accurate detection and typing methods in outbreak situations. Further, for successful management of E. faecium, continual innovation in the fields of diagnostics, treatment, and eradication is necessary.

中文翻译：

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粪肠球菌：从微生物学见识到对感染控制和诊断的实用建议。

粪肠球菌在进化的早期就具有使其成为成功的医院病原体的特征。粪肠球菌固有的坚韧性，可增强对抗生素和环境压力的抵抗力，使该物种在医院环境中壮成长。抗生素在医学中的持续广泛使用已成为粪肠球菌成为高效率医院病原体的进化的重要驱动力。为了成功地预防和减少耐万古霉素的粪肠球菌（VREfm）的医院感染，必须集中精力减少VREfm的携带和传播。这篇综述的目的是将粪肠球菌的微生物学见解纳入实际的感染控制建议中，以减少医院获得的VREfm的传播（运输和感染）。VREfm的传播可以通过加强清洁程序，抗生素管理，针对高危人群的VREfm运输的快速筛查以及在暴发情况下通过准确的检测和分型方法来识别传播途径来控制。另外，为了成功地处理粪肠球菌，在诊断，治疗和根除领域中必须不断创新。