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Enterococcal bacteremia in a medical center
M Y Peng1, T G Young, C H Yang
1Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|November 1, 1994
Summary
Enterococci are significant nosocomial pathogens causing high mortality bacteremia, particularly in elderly patients with underlying conditions. Early consideration of enterococcal bacteremia is crucial for effective sepsis treatment.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Hospital Epidemiology
Background:
- Enterococci are increasingly recognized as significant nosocomial pathogens.
- Enterococcal bacteremia is associated with high mortality rates and diverse infection sites.
- This study aimed to assess the impact of enterococci in a hospital setting and identify mortality risk factors.
Purpose of the Study:
- To establish the significance of enterococci as nosocomial pathogens.
- To characterize the clinical presentation of enterococcal bacteremia.
- To identify risk factors associated with mortality in enterococcal bacteremia.
Main Methods:
- Retrospective analysis of 181 cases of enterococcal bacteremia from 1988 to 1992.
- Data collection included patient demographics, underlying conditions, infection sources, and outcomes.
- Antimicrobial susceptibility testing was performed.
Main Results:
- 118 of 181 episodes were nosocomial infections.
- Gastrointestinal tract was the most common source of infection (69.6%).
- High resistance to gentamicin (89.5%) and significant mortality (47.6% overall, 36.4% with specific therapy) were observed.
Conclusions:
- Enterococci are important nosocomial pathogens with high associated mortality.
- Elderly patients with comorbidities like malignancy or diabetes are at higher risk.
- Consider enterococcal bacteremia in sepsis cases from GI/biliary tract, especially with cephalosporin treatment failure.