Clinical features of enterococcal bacteremia due to ampicillin-susceptible and ampicillin-resistant enterococci: An eight-year retrospective comparison study

Hamada, Yohei; Magarifuchi, Hiroki; Oho, Megumi; Kusaba, Koji; Nagasawa, Zenzo; Fukuoka, Mami; Yamakuchi, Hiroki; Urakami, Toshiharu; Aoki, Yosuke

doi:10.1016/j.jiac.2015.04.001

Cited by 23 publications

(27 citation statements)

References 11 publications

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“…Abdominal infections, central venous catheters, and unknown sources were the most common foci of enterococcal BSIs in the present study, is similar to the prior studies [28]. However, no infective endocarditis was observed in our study.…”

Section: Discussionsupporting

confidence: 92%

“…E. faecalis was reported to be the most common pathogen for nosocomial enterococcal BSIs in most investigations, and the ratio of E. faecium was no more than 50% [1, 11, 20, 28]. However, a constant increase in E. faecium BSI rates was observed [11, 29], and the incidence of E. faecium BSIs exceeded E. faecalis BSI in 2009 in a 14-year study conducted at a Swiss tertiary hospital [29].…”

Section: Discussionmentioning

confidence: 99%

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Incidence, clinical characteristics, and outcomes of nosocomial Enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study

Zhang

Chang

et al. 2017

Antimicrob Resist Infect Control

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Background Enterococcus spp. are the common cause of nosocomial bloodstream infections (BSIs) with high morbidity and mortality. The purpose of this study was to characterize the incidence, clinical and microbiological features, and mortality of nosocomial enterococcal BSIs at a large Chinese tertiary-care hospital in Beijing, China.MethodsA retrospective cohort study on adult patients with nosocomial BSIs due to Enterococcus spp. was performed between January 1, 2012, and December 31, 2015 at the Chinese People’s Liberation Army General Hospital. Patients’ data were gathered by reviewing electronic medical records.ResultsA total of 233 episodes of BSI due to Enterococcus spp. occurred among 224 patients during these 4 years. The overall incidence was 3.9 episodes per 10,000 admissions. Enterococcus faecium (E. faecium) was the major pathogen (74%, 95% CI 68–80%), followed by Enterococcus faecalis (E. faecalis) (20%, 95% CI 15–25%). E. faecium showed higher antimicrobial resistance than E. faecalis. The 30-day mortality of nosocomial enterococcal BSI was 24% (95% CI 18–29%). Predictors for mortality included the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), impaired renal function, prior use of immunosuppressive agents, and appropriate empirical antimicrobial treatment.ConclusionsThis study emphasizes that Enterococcus spp. were major pathogens for nosocomial BSIs and associated with high mortality. Appropriate empirical antimicrobial treatment can improve outcomes. Vancomycin is the best choice for patients with E. faecium BSIs. Penicillins, aminoglycosides, fluoroquinolones, and vancomycin can be considered for patients with E. faecalis BSIs.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Incidence, clinical characteristics, and outcomes of nosocomial Enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study

Zhang

Chang

et al. 2017

Antimicrob Resist Infect Control

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“…Iron rich niches also occur in disease states such as haemochromatosis and thalassemia where iron homeostasis is defective (20, 21). E. faecalis is a significant opportunistic pathogen and biofilm development strengthens its tolerance to antimicrobial therapies and immune clearance (7-10). Enterococcal metabolic versatility supports its survival in diverse and complex environments and communities, thus increasing the possibility of dissemination to new niches when iron is present (47).…”

Section: Discussionmentioning

confidence: 99%

“…In both adults and neonates in intensive care settings, gastrointestinal perturbations can result in the replacement of the endogenous Enterococci with aminoglycoside-or vancomycin-resistant Enterococci (4-6). Enterococci are also opportunistic pathogens associated with surgical site and wound infections, bacteraemia, urinary tract infections (UTI), catheter-associated UTI (CAUTI), and endocarditis (7-10). These infections can become chronic through the development of biofilm which is inherently more tolerant to antimicrobial therapies and immune clearance, a problem compounded by multidrug resistant Enterococci in healthcare settings.…”

Section: Introductionmentioning

confidence: 99%

Extracellular Electron Transfer PowersEnterococcus faecalisBiofilm Metabolism

Keogh

Lam

Doyle

et al. 2017

Preprint

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“…These findings suggest that patients receiving quinolones are at an increased risk of E. faecium acquisition (2011) reported a potential relationship between E. faecium bacteremia and cancer. Other reports showed that the use of carbapenems is an independent predictor of E. faecium bacteremia (Gudiol et al 2013;Hamada et al 2015). The use of broad-spectrum β-lactams including carbapenems in cancer patients is common in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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

Namikawa

Yamada

Shibata

et al. 2017

Tohoku J. Exp. Med.

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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.

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Clinical features of enterococcal bacteremia due to ampicillin-susceptible and ampicillin-resistant enterococci: An eight-year retrospective comparison study

Cited by 23 publications

References 11 publications

Incidence, clinical characteristics, and outcomes of nosocomial Enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study

Incidence, clinical characteristics, and outcomes of nosocomial Enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study

Extracellular Electron Transfer PowersEnterococcus faecalisBiofilm Metabolism

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

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