Trends in the Incidence and Antibiotic Resistance of Enterococcal Bloodstream Isolates: A 7-Year Retrospective Multicenter Epidemiological Study in Italy

Monticelli, Jacopo; Bella, Stefano Di; Giacobbe, Daniele Roberto; Amato, Gerardino; Antonello, Roberta Maria; Barone, Eugenia; Brachelente, Giovanni; Busetti, Marina; Carcione, Davide; Carretto, Edoardo; Conaldi, Pier Giulio; Degl’Innocenti, Linda; Puente, Filippo Del; Knezevich, Anna; Luzzaro, Francesco; Mainelli, Maria Teresa; Marchese, Anna; Meledandri, Marcello; Mencacci, Antonella; Miragliotta, G.; Monaco, Francesco; Morabito, Francesca; Nardini, Paola; Principe, Luigi; Riggio, Daniela; Viaggi, Valentina; Viscoli, Claudio; Luzzati, Roberto

doi:10.1089/mdr.2020.0147

Cited by 6 publications

(2 citation statements)

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“…Nonetheless, ampicillin-resistant E. faecium was not reported frequently in previous studies and outside Europe [ 2 , 4 , 8 – 11 ]. This data did not likely represent Italy’s basic epidemiology [ 3 , 5 , 7 , 11 ]; therefore, more recent homogeneous studies are warranted.…”

Section: Discussionmentioning

confidence: 92%

“…Enterococcus faecalis and Enterococcus faecium have become increasingly common causes of healthcare-associated infections (HAIs) in the United States (US) and Europe [ 1 – 3 ]. Six-year surveillance on Gram-positive organisms causing bacteraemia in US and European hospitals reported that 10.6% and 9.4% of bloodstream infections (BSI) were due to E. faecalis and E. faecium , which constitute, respectively, the second and the third pathogen in terms of frequency after Staphylococcus aureus [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

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Clinical and microbiological characteristics of bloodstream infections caused by Enterococcus spp. within internal medicine wards: a two-year single-centre experience

et al. 2022

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Enterococcal bloodstream infections (E-BSI) constitute the second cause of Gram-positive bacterial BSI in Europe with a high rate of in-hospital mortality. Furthermore, E-BSI treatment is still challenging because of intrinsic and acquired antibiotic resistances. We conducted a retrospective, 2-year, observational, single-centre study to evaluate clinical outcome and risk factors for E-BSI mortality in internal medicine wards. 201patients with E-BSI were included in the analysis. Infection rate was 2.4/1000 days of hospital admission. Most E-BSI were hospital acquired (78.1%). The median age was 68 years. Charlson Comorbidity Index, adjusted for age, was 5 (range 4–6). Patients with E-BSI frequently had at least one invasive device, predominantly a central venous (73%) or a bladder catheter (61.7%). Enterococcus faecium accounted for 47.94% of E-BSI (resistance rate to ampicillin or vancomycin was 22.2 and 23.3%, respectively) and Enterococcus faecalis for 52.08% (resistance rate to ampicillin or vancomycin was 3.1 and 2.2%, respectively). Among all E-BSI, 25% of patients received appropriate therapy. In total, 59% of E-BSI underwent echocardiography. At the multivariate analysis, resistance to vancomycin (OR 2.09, p = 0.025), sepsis (OR 2.57, p = 0.003) and septic shock (OR 3.82, p = 0.004) was a predictor of mortality. No difference in 28-day survival was observed between appropriate or inappropriate treatment, except for endocarditis. However, E-BSI sources in clinical practices are not always properly investigated, including the rule-out of intracardiac vegetations. We did not demonstrate a difference in mortality for inappropriate therapy in the absence of endocarditis in comorbid patients with a long history of medicalization.

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