Análisis de 182 episodios de bacteriemia por enterococo: estudio de la epidemiología, microbiología y evolución clínica

Martínez-Odriozola, Pedro; Muñoz-Sánchez, Josefa; Gutiérrez-Macías, Alfonso; Arriola-Martínez, Paula; Montero-Aparicio, Esperanza; Ezpeleta-Baquedano, Carmen; Cisterna-Cáncer, Ramón; Villa, Felipe Miguel de la

doi:10.1157/13109986

Cited by 17 publications

(11 citation statements)

References 16 publications

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“…We observed that 57% of the BSI episodes were hospital-acquired. This concurs with that published by other studies in which the majority of the episodes enterococcal BSI episodes are hospital acquired 5,6 . A 39% of the episodes were polymicrobial.…”

Section: Discussionsupporting

confidence: 93%

“…Similar to other studies that have been described 4,5 , enterococcal bloodstream infection is related to patients with a high number of co-morbidities and severe underlying illnesses. In our study, 96% of all patients presented a Charlson index higher than 2.…”

Section: Discussionsupporting

confidence: 73%

“…represents 10% of all blood cultures isolates in Europe and their incidence is rising 4,5 . This is in part because it often occurs in patients with prolonged hospitalization, co-morbidities, or who are undergoing instrumental manipulation or are under antibiotic pressure [4][5][6] . Enterococci, compared to other Gram-positive cocci such as S. aureus or S. pyogenes, has low pathogenicity and lacks important virulence factors.…”

mentioning

confidence: 99%

“…Despite that, it is able to form biofilms associated with biomedical devices. Enterococcus spp is inherently resistant to certain antibiotics used frequently, but also has an innate ability to acquire new mechanisms of resistance especially in the case of E. faecium 5 . Despite E. faecalis is the specie most frequently isolated from cultures, E. faecium has been described as a microorganism with more clinical relevance than E. faecalis (because of its virulence and main resistant mechanisms).…”

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confidence: 99%

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Predictors of mortality and poor outcome in cancer patients with E. faecium bloodstream infection

Pérez‐García

Beunza²,

Gea³

et al. 2015

An Sist Sanit Navar

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results. After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality.conclusion. Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series. Métodos. Se analizaron datos demográficos, clínicos y microbiológicos (Enero 1998-Junio 2011).resultados. El análisis multivariable demostró que la presencia de una sonda urinaria se asoció a mal pronós-tico a los 7 días y alta mortalidad del paciente al final del estudio. Un índice de Charlson elevado se asoció a un aumento en la mortalidad a los 7 días.conclusión. En nuestro estudio, la presencia de sonda urinaria se asoció con mal pronóstico del paciente a los 7 días y aumento de la mortalidad.Palabras clave. Bacteriemia. Enterococcus faecium. Cáncer. Predictores.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Predictors of mortality and poor outcome in cancer patients with E. faecium bloodstream infection

Pérez‐García

Beunza²,

Gea³

et al. 2015

An Sist Sanit Navar

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“…Enterokok bakteriyemileri daha çok yaşlı ve tıbbi problemleri olan veya immün yetmezliği olup uzun süredir hastanede yatan, antibiyotik tedavisi alan hastalarda görülür ve mortalitesi %30'lardadır (9,10,22). Enterokok bakteriyemilerinde uzun süreli santral venöz kateterizasyon, üriner kateterizasyon, multipl travma, majör yanıklar, hemodiyaliz, nötropeni, gastrointestinal kolonizasyon, barsak rezeksiyonu veya diğer abdominal cerrahi girişimler, hastanede yatış süresinin uzaması, hematolojik maligniteli hastalarda uzun süreli tedavi uygulamaları ve sefalosporin grubu antibiyotik tedavilerinin önemli risk faktörleri olduğu bildirilmektedir (9,16,17,(22)(23)(24)(25)(26). Çalışmamızda enterokok bakteriyemisinde hastaya ait risk faktörlerini, immünosüpresyon varlığı (p=0.017), KVS hastalığı (p<0.001), kronik karaciğer parenkim hastalığı (p=0.013), açık yara (p<0.001), GİS hastalığı (p=0.012) ve KBY (p<0.001) olarak saptadık.…”

Section: İrdelemeunclassified

Evaluation of Risk Factors in Enterococcal Bloodstream Infections

Alkan¹,

Kuloğlu²,

Akata³

2016

Klimik Dergisi

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Objective: The aim of this retrospective case-control study was to determine the epidemiology and to evaluate risk factors for the development of enterococcal bloodstream infections and risk factors involved in mortality of adult patients in a tertiary care teaching hospital between February 2010 and February 2011. Methods: A total of 95 enterococcal bacteremia episodes were identified among 28 593 patients hospitalized during the study period. Control group was selected among patients who had no signs and symptoms of bacteremia and had negative blood cultures during the study period. In each case, there had to be two randomized control cases. Results:The most frequent isolates were Enterococcus faecalis (n=46, 48.4%) and E. faecium (n=45, 47.4%). There was only one vancomycin-resistant E. faecalis (vanA genotype) and one E. gallinarum. Eighty four (88.4%) patients were identified to have nosocomial infection. The most common primary sites were central venous catheter (32.7%) and urinary tract (14.7%). Six cases of infective endocarditis and two cases of meningitis due to enterococci were also identified. Polymicrobial bacteremia occurred in 39 (41%) patients. Immunosuppression, cardiovascular disease, chronic liver parenchymal disease, gastrointestinal tract disease, chronic renal failure, hemodialysis, an open wound, Foley catheter, surgery other than abdominal operation, antacid use, hospitalization in the last one month, prolonged hospitalization (>15 days), exposure to antimicrobial therapy prior to bacteremia and inappropriate empirical therapy were the risk factors significantly associated with enterococcal bloodstream infections. In the multivariate logistic regression analysis, three factors were independently associated with mortality including high Charlson index (p=0.000), intensive care unit admission (p=0.016) and isolation of E. faecium from blood cultures (p=0.49). Conclusions: It should be considered that severely ill patients with prolonged hospitalization, those undergoing invasive procedures or receiving inappropriate antibiotic therapy have a high risk of enterococcal bacteremia and those with serious underlying comorbidities are likely to be unresponsive to treatment and have a higher mortality. gallinarum).Olguların 84 (%88.4)'ünde hastane kökenli bakteriyemi saptandı. En sık primer infeksiyon kaynağı santral venöz kateter (%32.7) ve üriner sistem (%14.7) idi. Altı hastada bakteriyemiye eşlik eden infektif endokardit, iki hastada menenjit saptandı. Enterokok bakteriyemilerinin 39 (%41)'u polimikrobiyal bakteriyemiydi. İmmünosüpresyon, kardiyovasküler sistem hastalığı, kronik karaciğer parenkim hastalığı, gastrointestinal sistem hastalıkları, kronik böbrek yetmezliği, diyaliz tedavisi, açık yara, Foley sondası, abdominal cerrahi dışındaki cerrahi girişim, antasid kullanımı, son bir aylık dönemde hastanede yatış, hastanede yatış süresinin 15 günden fazla olması, bakteriyemi öncesi antibiyotik kullanımı ve uygun olmayan ampirik antibiyotik tedavisi, olgu grubunda anlamlı olarak daha...

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Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia in cancer patients

Conde-Estévez

Grau

Albanell

et al. 2010

Eur J Clin Microbiol Infect Dis

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The purpose of this investigation was to compare the risk factors, clinical features and outcomes in cancer patients with bacteraemia caused by vancomycin-susceptible Enterococcus faecalis and E. faecium. A retrospective, observational 7-year study was carried out in a 450-bed, acute-care university-affiliated hospital. We performed univariate comparisons between the two groups and then multivariate analysis to identify patient risk factors for E. faecium isolation. Seventy-three patients were included in the analysis: 54 (74.0%) with bacteraemia caused by E. faecalis and 19 (26.0%) by E. faecium. The Simplified Acute Physiological Score (SAPS) value was significantly greater in E. faecium isolates (40.7 vs. 35.2; p = 0.009). Diabetes mellitus was more frequently diagnosed in patients with E. faecium bacteraemia (52.6% vs. 24.1%; p = 0.021). Prior penicillin exposure was more frequent in patients with E. faecium bacteraemia (68.4% vs. 29.6%; p = 0.003). There was a trend toward higher mortality in E. faecium bacteraemia patients (47.4% vs. 25.9%; p = 0.084). Independent patient risk factors for E. faecium isolation were prior penicillin exposure (odds ratio [OR], 6.479; p = 0.003) and SAPS > 34 (OR, 6.896; p = 0.009). When compared to E. faecalis bacteraemia, E. faecium bacteraemia in cancer patients is independently associated with more severe illness and prior use of penicillins; therefore, empiric treatment which would cover E. faecium should be considered in cancer patients suspected of having bacteraemia.

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Análisis de 182 episodios de bacteriemia por enterococo: estudio de la epidemiología, microbiología y evolución clínica

Cited by 17 publications

References 16 publications

Predictors of mortality and poor outcome in cancer patients with E. faecium bloodstream infection

Predictors of mortality and poor outcome in cancer patients with E. faecium bloodstream infection

Evaluation of Risk Factors in Enterococcal Bloodstream Infections

Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia in cancer patients

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