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Enterococcal bacteremia in surgical patients.

D T Barrall, P R Kenney, G J Slotman

    Archives of Surgery (Chicago, Ill. : 1960)
    |January 1, 1985
    PubMed
    Summary

    Enterococcal bacteremia in surgical patients often follows antibiotic use and catheterization. Early antienterococcal therapy may improve survival in high-risk patients with gram-positive bacteremia.

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    Area of Science:

    • Infectious Diseases
    • Surgical Infections
    • Antimicrobial Resistance

    Background:

    • Enterococcal bacteremia is a significant concern in surgical settings.
    • Risk factors include prior antibiotic administration, central venous catheters, and gastrointestinal operations.

    Purpose of the Study:

    • To identify risk factors and outcomes of enterococcal bacteremia in surgical patients.
    • To evaluate the efficacy of antienterococcal therapy in a specific high-risk subgroup.

    Main Methods:

    • Retrospective analysis of 73 surgical patients with enterococcal bacteremia.
    • Identification of preceding conditions, portals of entry, and therapeutic interventions.

    Main Results:

    • Common preceding factors: antibiotic use (58), central venous catheters (52), other bacteremia (44), GI operations (41).
    • Surgical wounds and UTIs were frequent entry points; overall mortality was 42%.
    • High mortality risk associated with preceding gram-positive bacteremia and prolonged cephalosporin use.

    Conclusions:

    • Enterococcal bacteremia in surgical patients is linked to antibiotic exposure and invasive procedures.
    • Patients with gram-positive bacteremia and cephalosporin exposure represent a high-mortality subgroup.
    • Specific antienterococcal therapy showed potential benefit in this subgroup.

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