Pili prove pertinent to enterococcal endocarditis.

Enterococcus faecalis is an important agent of endocarditis and urinary tract infections, which occur frequently in hospitals. Antimicrobial therapy is complicated by the emergence of drug-resistant strains, which contribute significantly to mortality associated with E. faecalis infection. In this issue of the JCI, Nallapareddy and colleagues report that E. faecalis produces pili on its surface and that these proteinaceous fibers are used for bacterial adherence to host tissues and for the establishment of biofilms and endocarditis (see the related article beginning on page 2799). This information may enable new vaccine strategies for the prevention of E. faecalis infections.