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Nosocomial bacteremia due to Enterococcus faecalis without endocarditis.

W Graninger1, R Ragette

  • 1Department of Chemotherapy, University of Vienna, Austria.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 1, 1992
PubMed
Summary

Nosocomial Enterococcus faecalis bacteremia, often linked to urinary tract infections, showed a 37% mortality rate. Antibiotic choice, including penicillins and glycopeptides, did not significantly alter survival outcomes in this study.

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Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • Enterococcus faecalis is a significant cause of nosocomial infections.
  • Bacteremia due to E. faecalis presents a challenge in hospital settings.
  • Understanding risk factors and outcomes is crucial for patient management.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of Enterococcus faecalis bacteremia in a university hospital.
  • To identify common sources and preceding antibiotic use in patients with E. faecalis bacteremia.
  • To evaluate the impact of different antibiotic treatments on mortality rates.

Main Methods:

  • A 2-year observational study was conducted at a 2,200-bed university hospital.
  • Data were collected on 111 patients with E. faecalis bacteremia, with 55 eligible for detailed evaluation.

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  • Patient demographics, infection sources, prior antibiotic exposure, and treatment regimens were analyzed.

    • Main Results:

    • The urinary tract was the most common entry site (25%), followed by intraabdominal infections (13%) and wounds (11%).
    • Prior antibiotic administration, including cephalosporins, carbapenems, and fluoroquinolones, was noted in many cases.
    • Treatment with penicillins or glycopeptides resulted in a 37% mortality rate; adding high-dose aminoglycosides did not improve survival.

    Conclusions:

    • Enterococcus faecalis bacteremia is associated with significant mortality, irrespective of patient factors or common entry sites.
    • Current treatment strategies using penicillins and glycopeptides, even with aminoglycoside addition, show limited efficacy in reducing mortality.
    • Further research into novel therapeutic approaches for E. faecalis bacteremia is warranted.