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Update data/rag/knowledge_base/Enterococcus/faecium.json

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data/rag/knowledge_base/Enterococcus/faecium.json CHANGED
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+ {
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+ "genus": "Enterococcus",
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+ "species": "faecium",
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+ "full_name": "Enterococcus faecium",
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+ "clinical_significance": "A highly antimicrobial-resistant Enterococcus species and major cause of hospital-associated infections. Vancomycin-resistant E. faecium (VREfm) carrying VanA/VanB genes is a critical public health concern. Causes bacteremia, endocarditis, intra-abdominal infection, and UTIs.",
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+ "phenotype_profile": {
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+ "morphology": "Gram-positive cocci in chains.",
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+ "culture": "Typically non-hemolytic or α-hemolytic.",
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+ "biochemical": [
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+ "PYR positive",
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+ "Bile esculin positive",
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+ "Growth in 6.5% NaCl",
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+ "Arabinose positive (key for differentiation)",
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+ "Motility negative",
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+ "Indole negative"
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+ ]
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+ },
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+ "differentiation": {
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+ "from close species": [
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+ "Arabinose positive → major differentiator vs E. faecalis (arabinose–).",
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+ "Ampicillin resistance common due to altered PBP5.",
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+ "Primary species associated with VanA/VanB vancomycin resistance."
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+ ],
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+ "from other genera": [
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+ "Growth in NaCl + bile esculin + PYR eliminates Streptococcus.",
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+ "Gas-negative glucose fermentation differentiates from Leuconostoc (gas-producing)."
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+ ]
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+ },
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+ "virulence_factors": [
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+ "Biofilm formation",
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+ "Surface adhesins (Esp)",
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+ "Vancomycin resistance genes (VanA/VanB)",
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+ "Multidrug efflux pumps",
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+ "Altered PBP5 conferring β-lactam resistance"
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+ ],
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+ "confirmation_methods": [
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+ "MALDI-TOF MS",
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+ "Arabinose fermentation test",
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+ "VanA/VanB PCR for VRE",
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+ "WGS for outbreak detection"
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+ ],
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+ "treatment_notes": [
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+ "Ampicillin usually ineffective due to high-level resistance.",
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+ "For VRE: linezolid or daptomycin are preferred agents.",
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+ "Daptomycin high-dose therapy required for bacteremia.",
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+ "Tigecycline may be active for intra-abdominal infections."
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+ ],
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+ "notes": "A leading cause of nosocomial bacteremia in many regions.",
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+ "references": [
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+ "Vancomycin-resistant Enterococcus surveillance",
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+ "Hospital outbreak genomics"
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+ ]
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+ }