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05:02
A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures
Published on: February 10, 2011
[Differentiating clinical characteristics in bacteriemia caused by Enterococcus faecalis or Enterococcus faecium]
David Conde-Estévez1, Luisa Sorli, José Antonio Morales-Molina
1Servicio de Farmacia, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España. dconde@hospitaldelmar.cat
Enfermedades Infecciosas Y Microbiologia Clinica
|September 29, 2009
Summary
Enterococcal infections are increasing. This study identified factors predicting Enterococcus faecium bacteremia, aiding targeted empirical treatment for severe infections like endocarditis.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Enterococci cause severe infections, including endocarditis and bacteremia.
- The incidence of enterococcal infections has risen significantly in recent decades.
- Understanding predisposing factors for E. faecalis versus E. faecium is crucial for effective empirical treatment.
Purpose of the Study:
- To identify clinical and demographic factors associated with Enterococcus faecium bacteremia.
- To differentiate risk factors for E. faecalis and E. faecium infections.
- To inform improved empirical antibiotic strategies for enterococcal bacteremia.
Main Methods:
- Retrospective analysis of 228 enterococcal bacteremia episodes from 2000-2006.
- Comparison of demographic, clinical, and microbiological data between E. faecalis and E. faecium cases.
- Multivariate logistic regression to identify independent predictors of E. faecium bacteremia.
Main Results:
- E. faecium bacteremia was associated with surgical ward admission, prior cephalosporin/carbapenem use, penicillin exposure, high SAPS score, and hepatobiliary disease.
- All E. faecalis isolates were ampicillin-susceptible, contrasting with only 25% of E. faecium isolates.
- A single vancomycin-resistant isolate was identified.
Conclusions:
- Differing antibiotic susceptibility profiles between E. faecalis and E. faecium necessitate species-specific risk factor identification.
- Knowledge of predisposing factors aids in selecting appropriate empirical therapy for enterococcal bacteremia.
- Clinical and historical factors can predict E. faecium acquisition, guiding treatment decisions.
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