Enterococcal bacteremia in a medical intensive care unit

We reviewed retrospectively from 1982 through 1984 35 cases of enterococcal bacteremia in a medical ICU. Of these, 27 patients acquired nosocomial infections; their mean previous hospital stay was 17 +/- 4 days. Thirteen had a serious debilitating disease; 20 received previous antibiotic therapy. The infection focus was not found in 16 patients. The deaths of nine patients were related directly to enterococcal bacteremia. Mortality was significantly lower in patients with nosocomial infections, with appropriate antibiotic therapy just after the start of the infection, without debilitation, and when the infection focus was discovered. In a medical ICU, some patients appear to be particularly predisposed to enterococcal bacteremia. When these patients develop a serious infection without obvious source, an appropriate antibiotic therapy for Enterococcus should be promptly initiated.