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Comparison of clinical outcomes and risk factors in polymicrobial versus monomicrobial enterococcal bloodstream

Abdalhamid M Lagnf1, Evan J Zasowski1, Kimberly C Claeys1

  • 1Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI.

American Journal of Infection Control
|April 16, 2016
PubMed
Abstract

Insights

Polymicrobial enterococcal bloodstream infections (EBSIs) did not show increased mortality compared to monomicrobial EBSIs. Risk factors for polymicrobial EBSIs include recent chemotherapy and antibiotic exposure.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Epidemiology

Background:

  • Enterococcal bloodstream infections (EBSIs) are often polymicrobial, yet data on outcomes and risk factors are limited.
  • This study aimed to compare outcomes and identify risk factors for polymicrobial versus monomicrobial EBSIs.

Purpose of the Study:

  • To investigate the clinical outcomes, specifically 30-day mortality, of polymicrobial EBSIs compared to monomicrobial EBSIs.
  • To identify independent predictors and risk factors associated with polymicrobial EBSIs.

Main Methods:

  • A retrospective, single-center, matched cohort study design was employed.
  • 142 pairs of patients with polymicrobial EBSI were matched 1:1 with patients with monomicrobial EBSI based on age, EBSI source, Pitt bacteremia score, and enterococcal species.
  • Conditional logistic regression was used to analyze predictors of 30-day mortality and polymicrobial EBSI.

Main Results:

  • No significant difference in 30-day mortality was observed between monomicrobial (18.3%) and polymicrobial (21.1%) EBSI groups.
  • Independent predictors of 30-day mortality included recent chemotherapy/radiation, chronic renal disease, and higher Pitt bacteremia scores.
  • Recent chemotherapy/radiation and recent antibiotic exposure were associated with polymicrobial EBSI, while chronic hemodialysis showed a negative association.

Conclusions:

  • Polymicrobial EBSIs were not independently associated with increased 30-day mortality in this cohort.
  • Further research into the risk factors and clinical implications of polymicrobial EBSIs is warranted to guide management strategies and improve patient outcomes.
Keywords:
AntibioticsBacteremiaChemotherapyEnterococcus faecalisEnterococcus faeciumMortality

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