Attributable Mortality Rate and Duration of Hospital Stay Associated with Enterococcal Bacteremia

Abstract

The mortality rate of patients with cases of enterococcal bacteremia is high, although it has often been related to the patients' underlying conditions rather than to the infection itself. To analyze the attributable prognosis of enterococcal bacteremia (assessed by its attributable mortality rate and duration of hospital stay), a prospective, matched case-control study was done. All adults with an episode of enterococcal bacteremia without endocarditis were included. A control patient was randomly selected for every case patient and matched by sex, age and hospital ward. Univariate and multivariate analyses were performed. A total of 122 pairs were included, and incidence of enterococcal bacteremia was 2.3 episodes/1000 discharges. Crude 30-day mortality rates for case patients and control patients were 23% and 17%, respectively (P=.29); thus, the estimated attributable mortality rate was 6% (95% confidence interval, -4% to 16%). The mean duration of hospital stay of case patients and control patients were 38 and 17 days, respectively (P<.001); thus, the estimated attributable duration of hospital stay was 21 days (95% CI, 7-32 days). Enterococcal bacteremia without endocarditis does not increase risk of death by itself but extends the duration of hospital stay of patients who develop it.

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

“…In Furuno´s study, the previous antibiotic exposure and previous hospitalization are risk factors for the E. faecalis and the E. faecium acquired 18 . In the same way, in Patterson´s and Caballero´s studies postulated that the previous use of antibiotics was related to fatal outcome 14,15 . We observed that 57% of the BSI episodes were hospital-acquired.…”

“…However, while the presence of this last one (indwelling urinary catheter) has been demonstrated by the analysis as having statistical differences [worse 7-days outcome (OR, 26.92; 95% CI, 2.28-317; p= 0.009), and mortality at discharge (OR, 9.14; 95% CI, 1.10-75.8; P= 0.040)], that does not happen with the central venous catheter (no significative differences). Caballero-Granado et al, in his study about the attibutable mortality rate and duration hospital stay related to the enterococcal BSI, showed that the presence of an indwelling urinary catheter was associated with global mortality increase 14 . In their study, Patterson et al, defined the presence of an indwelling urinary catheter as a potential risk factor for the Enterococcus spp.…”

“…These studies have demonstrated that correct selection and early initiation of treatment is associated with lower attributable mortality and therefore better patient prognosis. Caballero-Granado et al demonstrated that inappropriate treatment was a poor prognostic factor 14 . In our series, 96% of our patients received adequate treatment.…”

Enterococcus faecium and Enterococcus faecalis in endodontic infections: antibiotic resistance profile and susceptibility to photodynamic therapy

“…In recent years, the Enterococcus species have received increased attention due to their capacity to acquire resistant to several antibiotics, including erythromycin, tetracycline, chloramphenicol, azithromycin, and vancomycin [10,38,40]. In our study, susceptibility to antibiotics was assayed by the E-test method that provides easy handling, interpretation, and reliability [41].…”

Peritoneal Dialysis Peritonitis Caused by Enterococcus avium

“…Editor: Enterococcus species are normal human bowel flora, but they can also be major pathogens causing community-acquired urinary tract infections, bacteremia, and antibiotic-resistant nosocomial infections (1). Among its kindred, E. faecalis and E. faecium account for more than 90% of infections; other species (E. casseliflavus, E. gallinarium, E. flavescens) constitute fewer than 5% of cases (2).…”