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Enterococcal bacteremia in a medical intensive care unit
1Medical ICU, Hôpital de Bicêtre, Université Paris-Sud, Le Kremlin-Bicêtre, France.
Abstract:
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.
Insights
Enterococcal bacteremia in intensive care units (ICUs) affects predisposed patients, often linked to prior antibiotic use and prolonged hospital stays. Prompt, appropriate antibiotic therapy and identifying the infection source significantly reduce mortality.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Enterococcal bacteremia is a significant concern in intensive care units (ICUs).
- Nosocomial infections and prior antibiotic exposure are common in affected patients.
- Identifying risk factors and outcomes is crucial for patient management.
Purpose of the Study:
- To retrospectively analyze cases of enterococcal bacteremia in a medical ICU.
- To identify patient characteristics and factors associated with mortality.
- To inform prompt and appropriate treatment strategies.
Main Methods:
- Retrospective review of 35 enterococcal bacteremia cases from 1982-1984 in a medical ICU.
- Analysis of patient demographics, previous treatments, infection sources, and outcomes.
- Comparison of mortality rates based on identified factors.
Main Results:
- 27 out of 35 patients acquired nosocomial enterococcal bacteremia, with a mean prior hospital stay of 17 days.
- 13 patients had serious debilitating diseases, and 20 received prior antibiotic therapy.
- Mortality was lower in cases with identified infection sources, appropriate early antibiotic therapy, and without debilitation.
Conclusions:
- Certain patient groups in medical ICUs are predisposed to enterococcal bacteremia.
- Prompt initiation of appropriate antibiotic therapy for Enterococcus is vital, especially for infections without an obvious source.
- Identifying the infection focus and managing debilitating conditions are key to improving outcomes.