An Analysis of 110 Serious Enterococcal Infections Epidemiology, Antibiotic Susceptibility, and Outcome

Abstract

A prospective, observational study of 110 patients with serious infections due to Enterococcus spp. in 6 university and community teaching hospitals in Connecticut was conducted to define the epidemiology of community and nosocomial serious enterococcal infections and to determine risk factors, including antibiotic resistances, that contribute to outcome. Serious community and nosocomial enterococcal infections involved a variety of sites, and antibiotic resistance was common. Types of infection by major organ system were cardiovascular, 54% (catheter-related bacteremia 28%, primary bacteremia 18%, endocarditis 6%, septic thrombophlebitis 1%); intra-abdominal, 13% (including cholangitis, 6%); renal, 13%; skin and soft tissue, 5%; bone and joint, 4%; pleuropulmonary, 4%; central nervous system, 3%; deep surgical wound, 3%; and endometritis, 2%. Sixty-one percent of infections were nosocomial; 48% of these occurred in the intensive care unit. Enterococcus faecium was responsible for 20% of all infections. Antibiotic resistances among the infections included high-level gentamicin resistance (26%), ampicillin resistance (10%), and vancomycin resistance (8%). Clinical cure was achieved in 64% of patients; 6.8% of patients relapsed, 6.8% had recurrence of the infection with a different pathogen, and overall mortality was 23%. Ampicillin resistance and a high acute physiology and chronic health evaluation (APACHE) II score were highly predictive of lack of cure.

A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis

“…The rate of enterococci infection was among the highest when compared with the literature data (3-20%) (10,12,14,18). It is well known that enterococcal bacteremia is a serious infection, associated with mortality rates between 23% and 46% (19)(20)(21)(22). But in our study mortality of enterococcal endocarditis was highest compared with other agents (46%).…”

The antibiotic resistance of Enterococcus strains isolated from blood cultures

“…Bu nedenle tür düzeyinde ay-rıma gidilmesi tedavinin planlanması aşamasında önem arzetmektedir 16 . Çok sayıda çalışmada E.faecium suşla-rında başta glikopeptitler olmak üzere antibiyotik direnç oranlarının E.faecalis'e göre daha yüksek olduğu bildirilmektedir 10,17,18 . Çalışmamızda izole edilen E.faecium suş-larında, vankomisin ve teikoplanin direnci %24 oranında bulunurken, E.faecalis ile E.hirae suşlarının tümü vankomisin ve teikoplanine duyarlı bulunmuştur.…”

Clinical Characteristics and Low Susceptibility to Daptomycin in <i>Enterococcus faecium</i> Bacteremia

“…Enterococci cause urinary tract, hepatobiliary, catheterrelated bloodstream, and surgical wound infections, as well as infective endocarditis and bacteremia (Kajihara et al 2015). The in-hospital mortality rate of patients with enterococcal bacteremia is high, ranging from 19%-30% (Noskin et al 1995;Patterson et al 1995;McBride et al 2010;Conde-Estévez et al 2011); thus, enterococci are considered a clinically important pathogen.…”