Comparison of Risk Factors and Outcome in Patients with Enterococcus faecalis vs Enterococcus faecium Bacteraemia

Abstract

The purpose of our study was to determine retrospectively the risk factors for the acquisition of Enterococcus faecalis vs E. faecium bacteraemia, as well as the clinical outcomes of these patients. 62 patients with Enterococcus faecalis bacteraemia were compared to 31 patients with E. faecium bacteraemia. Haematologic malignancies, neutropenia, high-risk source and previous use of aminoglycosides, carbapenems, cephalosporins and clindamycin were significantly associated with E. faecium bacteraemia. Instead, urinary catheterization was found to be related to Enterococcus faecalis bacteraemia. The mortality rates within 7 d and 30 d were 13% and 27%, respectively, in patients with E. faecalis bacteraemia and 6% and 29%, respectively, in patients with E. faecium bacteraemia. There was no difference in mortality between E. faecalis and E. faecium bacteraemia, nor was there a difference in seriousness of disease at the time of bacteraemia. In the subgroups of patients with monomicrobial or clinically significant E. faecalis vs E. faecium bacteraemia, the mortality rates were similar to the results of all subjects. Our results do not support the theory that E. faecium would be a more virulent organism than E. faecalis.

Increase in Bloodstream Infection Due to Vancomycin-Susceptible Enterococcus faecium in Cancer Patients: Risk Factors, Molecular Epidemiology and Outcomes

“…In our study, and in line with some previous reports, we found no association between E. faecium BSI and increased mortality [8,9,14,28]. Interestingly, some in vitro studies have suggested that enterococcal virulence determinants are more frequently found in E.…”

Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

“…Most VRE isolates were Enterococcus faecium , whereas the VSE isolates were predominantly E. faecalis. To account for this difference, factors associated with VSE bacteraemia due to E. faecium (haematological malignancy and duration of neutropenia) and E. faecalis (urinary catheter use) [44], were included in the multivariable analysis. We also accounted for time at risk for enterococcal bacteraemia by adjusting in the multivariable analyses for the following factors occurring in the 30 days prior to bacteraemia (for VRE and VSE cases) and death or discharge (for controls): number of days of antibiotic administration, neutropenia and hypoalbuminaemia, and use of medical devices (e.g.…”