Clinical Characteristics and Low Susceptibility to Daptomycin in <i>Enterococcus faecium</i> Bacteremia

Abstract

Enterococcus faecium has high levels of resistance to multiple antibiotics, and the mortality due to E. faecium bacteremia is high. Accordingly, E. faecium strains with low susceptibility to daptomycin are a concern in clinical practice. This study assessed the predictive factors and prognosis of patients with bacteremia due to E. faecium as well as the antimicrobial susceptibility, particularly to daptomycin, among E. faecium isolates. The medical records of patients admitted to Osaka City University Hospital with E. faecalis (n = 60) and E. faecium (n = 48) bacteremia between January 2011 and March 2016 were retrospectively reviewed. The E. faecalis group (mean age: 62.0 years) included 22 women, and the E. faecium group (mean age: 59.1 years) included 19 women. Predictive factors for infection, prognosis, and isolate antimicrobial susceptibilities were evaluated. The mean Sequential Organ Failure Assessment score and mortality rate did not differ between the two groups. The independent predictors of E. faecium bacteremia in multivariate analysis included quinolone use (p = 0.025), malignancy (p = 0.021), and prolonged hospitalization (p = 0.016). Cardiovascular disease was associated with a reduced risk of E. faecium bacteremia (p = 0.015). Notably, the percentage of E. faecium isolates with low daptomycin susceptibility was higher than that of E. faecalis (8.5% vs. 0%, p = 0.036). Thus, E. faecium should be considered when administering antibiotic therapy to patients with a history of these predictors. Furthermore, the use of daptomycin should be avoided in case of E. faecium with low susceptibility to daptomycin.

The Prevalence, Isolation, and Antimicrobial Susceptibility Testing of Enterococcus Species From Various Clinical Samples in a Tertiary Care Hospital

“…Enterococci, growth on blood agar was found with circular colonies of 1-2 mm in diameter, and there was no growth on MacConkey. Enterococci are gram-positive bacteria stirring as pairs or short chains (Namikawa et al, 2017). A catalase test was performed.…”

Prevalence and anti-bio gram of Enterococcus species in different samples: A cross-sectional study

“…The growth on blood agar was found with circular colonies of 1-2 mm in diameter and no growth in MacConkey. Enterococci are gram-positive bacteria stirring as pairs or short chains (Namikawa et al, 2017). A catalase test was performed.…”