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Urinary Tract Infection with Enterococcus faecalis
- Henry S. Fraimow, MD; and
- James Dean, MD
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IN RESPONSE:
Dr. Jacoby is correct in noting that we were not the first to report a clinical isolate that required an antimicrobial agent for growth [1]. In addition to being a well-described laboratory phenomenon, streptomycin dependence has also been reported in several clinical isolates [2]. Of note, many of these antibiotic-dependent strains were also isolated from the urinary tract, an environment in which a large inoculum of organisms may be continuously exposed to high antibiotic concentrations for prolonged periods and in which an antibiotic-resistant organism may take the “next” evolutionary step toward the development of antibiotic dependence. As Dr. Jacoby has observed, various antibiotic-dependent strains have been isolated in the laboratory. In addition to their novelty, such strains can also be powerful tools for studying the basic mechanisms of antibiotic action and resistance [3]. It is perhaps not surprising that antibiotics can serve as positive regulators of bacterial growth, given that most of these compounds are natural products of soil organisms and that they may have once functioned as primitive cellular effector molecules [4, 5]. We agree that the prevalence of antibiotic-dependent bacteria is unknown and will remain so until we begin to search for such strains in the appropriate clinical settings.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
