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Risk factors for mortality associated with enterococcal bloodstream infections
L Stroud1, J Edwards, L Danzing
1National Nosocomial Infections Surveillance (NNIS) System, Hospital Infections Program, National Center for Infectious Diseases, Atlanta, Georgia 30333, USA.
Infection Control and Hospital Epidemiology
|September 1, 1996
Summary
Vancomycin resistance did not increase mortality risk in patients with enterococcal primary bloodstream infections (EPBI). Severe illness, age, and prior antibiotic use were key mortality predictors in these severe infections.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Nosocomial enterococcal primary bloodstream infections (EPBIs) are associated with significant mortality.
- Understanding risk factors for mortality is crucial for patient management and outcomes.
Purpose of the Study:
- To identify risk factors for mortality in patients with EPBI.
- To evaluate if vancomycin resistance in enterococci increases the risk of death.
Main Methods:
- Retrospective cohort study conducted across four hospitals.
- Analysis of 145 patients with EPBIs, comparing survivors and non-survivors.
- Assessment of various clinical factors, including device use, infection history, and antibiotic exposure.
Main Results:
- Mortality rate was 51% (74/145) among patients with EPBI.
- 18% (26/145) of isolates were vancomycin-resistant.
- Vancomycin resistance was not an independent predictor of mortality. Severity of illness (APACHE II, comorbidity index), age, prior use of third-generation cephalosporins or metronidazole, and female gender were independent predictors of mortality.
Conclusions:
- Vancomycin resistance did not independently predict death in patients with EPBI.
- EPBI indicates severe, life-threatening disease.
- Further research is needed to clarify the pathogenicity of enterococci and the role of vancomycin resistance in EPBI mortality.
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