<p>Clinical Characteristics And Risk Factors In Mixed-Enterococcal Bloodstream Infections</p>

Abstract

PurposeAlthough the enterococcal bloodstream infections (EBSI) are often observed in clinic, the mixed-EBSI are few reported. The aim of this study was to investigate the clinical characteristics and risk factors of mixed-EBSI in comparison with monomicrobial EBSI (mono-EBSI).MethodsA single-center retrospective observational study was performed between Jan 1, 2013 and Dec 31, 2018 in a tertiary hospital. All patients with EBSI were enrolled, and their data were collected by reviewing electronic medical records.ResultsA total of 451 patients with EBSI were enrolled including 157 cases (34.8%) with mixed-EBSI. The most common co-pathogens were Coagulase-negative Staphylococcus (26.86%), followed by Acinetobacter baumannii (23.43%) and Klebsiella pneumoniae (8.57%). In multivariable analysis, burn injury (adjusted odds ratio [aOR], 7.39; 95% confidence interval [CI], 2.69–20.28), and length of prior hospital stay (aOR, 1.01; 95% CI, 1.00–1.02) were associated with mixed-EBSI. Patients with mixed-EBSI developed with more proportion of septic shock (19% vs. 31.8%, p=0.002), prolonged length of intensive care unit (ICU) stay [9(0,25) vs. 15(2.5,36), p<0.001] and hospital stay [29(16,49) vs. 33(18.5,63), p=0.031]. The mortality was not significantly different between mixed-EBSI and mono-EBSI (p=0.219).ConclusionA high rate of mixed-EBSI is among EBSI, and Acinetobacter baumannii is the second predominant co-existed species, except for Coagulase-negative Staphylococcus. Burn injury and length of prior hospital stay are independent risk factors for mixed-EBSI. Although the mortality is not different, patients with mixed-EBSI might have poor outcomes in comparison with mono-EBSI, which merits more attention by physicians in the future.

Clinical characteristics and risk factors of polymicrobial Staphylococcus aureus bloodstream infections

“…A 6.1% (93/1537) frequency of polymicrobial SA-BSI was reported in a 772bed teaching hospital in Michigan in Khatib's study [11]. In our recently previous study [21], we also found that 34.8% cases (157/451) with enterococcal bloodstream infections were mixed with other pathogens like CNS, A. baumannii and Klebsiella pneumoniae. These studies suggest that the proportion of polymicrobial bloodstream infections is not rare, which deserves the attention of clinicians.…”

A structurally-characterized peroxomanganese(iv) porphyrin from reversible O2 binding within a metal–organic framework

“…S2 † ), close to the accessible surface reported for other metalated variants of PCN-224, 15 – 17 , 19 thereby confirming the retention of porosity upon metalation and the successful removal of solvent molecules from the pores. While several manganese porphyrin-containing MOFs have been reported, to our knowledge, 20 1 represents the first example of a MOF that features a four-coordinate Mn II porphyrin complex.…”

Clinical Characteristics, Risk Factors and Outcomes of Mixed Candida Albicans/Bacterial Bloodstream Infections

“…23.5% and 48.0% polymicrobial bacteremia were observed in A. baumannii bacteremia and K. pneumoniae bacteremia, respectively [21,22]. In terms of enterococcal BSIs, the 34.8% cases (157/451) were mixed with other pathogens such as CNS, A.baumannii, and K.pneumoniae [23]. Whether the mixed-CA/B-BSIs are really infrequent, it might be underestimated.…”