Enterococcal infections. The increasing threat of nosocomial spread and drug resistance.

Enterococcal nosocomial infections are becoming more common. Their multiple resistance mechanisms to various antibiotics pose serious therapeutic problems. Despite 40 years of intense development of antimicrobial agents, no agent surpasses the synergistic effects of a combination of a penicillin or vancomycin plus an aminoglycoside for treatment of enterococcal infections. New agents that have bactericidal activity against enterococci are needed as the incidence of resistant strains increases.