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Enterococcal bacteraemia 'silent but deadly': a population-based cohort study
Ivana Cabiltes1,2, Sarah Coghill3, Steven J Bowe4
1School of Medicine, Deakin University, Geelong, Victoria, Australia.
Internal Medicine Journal
|June 11, 2019
Summary
Enterococcal bacteraemia is linked to severe comorbidities and high mortality. Urological and colorectal cancers are significant predictors of 1-year mortality, highlighting the need for timely cancer screening in affected patients.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Oncology
Background:
- Enterococcal infections are associated with high mortality rates, often linked to the severity of underlying comorbidities.
- Understanding the epidemiology and risk factors for enterococcal bacteraemia is crucial for improving patient outcomes.
Purpose of the Study:
- To characterize the epidemiology, clinical features, outcomes, and mortality predictors in patients with enterococcal bacteraemia.
- To identify specific comorbidities that predict mortality in enterococcal bacteraemia cases.
Main Methods:
- A retrospective cohort study was conducted on enterococcal bacteraemia episodes between January 2010 and March 2017.
- Epidemiological data, clinical characteristics, outcomes, and mortality predictors were analyzed using descriptive statistics and logistic regression.
Main Results:
- The incidence of enterococcal bacteraemia was 19.9/100,000 person-years, with a median age of 71 years.
- Common comorbidities included gastrointestinal, urological, cardiovascular diseases, and malignancies. Urological malignancy (aOR=3.57) and colorectal cancer (aOR=4.47) were significant predictors of 1-year mortality.
- Infective endocarditis was present in 15% of patients, and 75% of those referred for colonoscopy had undiagnosed colorectal neoplasia.
Conclusions:
- Microbiological cure was inversely associated with 30-day mortality.
- Urological and colorectal malignancies are key predictors of 1-year mortality in enterococcal bacteraemia.
- Routine colonoscopy is recommended for patients with Enterococcus faecalis bacteraemia or infective endocarditis of unclear origin to screen for colorectal neoplasia.
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