Virulence Factors Associated with Enterococcus Faecalis Infective Endocarditis: A Mini Review.

INTRODUCTION:The enterococci are accountable for up to 20% of all cases of infective endocarditis, with Enterococcus faecalisE. faecalisINDIVIDUAL VIRULENCE FACTORS:Nine virulence factors have in particular been associated with E. faecalisin vitroex vivoPATHOGENESIS:The virulence factors promote a broad spectrum of events that together allow for disease development and progression. The infection is initiated through bacterial binding to ligands present at the site of infection after which the colonization can be accelerated through inter-bacterial attachment and modulation of the host immune response. The formation and growth of the vegetation provide protection and promote growth. Controlled degeneration of the vegetation appears to increase the likelihood of embolization and dissemination, without exposing protected bacteria. PROPHYLACTIC IMMUNIZATION:In most cases, active and passive immunization against associated virulence factors provided partial protection. FUTURE PROSPECTS:There is a need for further evaluation of the known virulence factors. Immunization against two or more virulence factors might be an effective prophylactic tool.