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Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia—a five-year retrospective review

  • S. J. McBrideEmail author
  • A. Upton
  • S. A. Roberts
Article

Abstract

The purpose of this study was to assess the epidemiology and outcomes of enterococcal bacteraemia. A retrospective review of demographic, microbiological and clinical data in patients 16 years of age and over with Enterococcus faecalis or E. faecium bacteraemia at Auckland City Hospital, New Zealand, from June 2002 to May 2007 was carried out. A total of 212 patients fulfilled the inclusion criteria, with 205 being included in the analysis. E. faecalis accounted for 86% (176/205) and E. faecium 14% (29/205) of the patients. Amoxycillin resistance occurred in 69% (20/29) of E. faecium isolates. High-level gentamicin resistance was present in 38% (65/171) of E. faecalis isolates and 25% (7/28) of E. faecium isolates (P = NS). No vancomycin-resistant enterococci were isolated. Healthcare association was present in 73% (149/205) of patients. Co-morbidities were present in 86% (176/205) of patients. The 7-day mortality was 13% (27/205) and the 30-day mortality 25% (52/205). On multivariate analysis, the 7-day mortality was statistically significantly associated with cirrhosis and shorter intravenous amoxycillin therapy. The 30-day mortality was statistically significantly associated with cirrhosis, malignancy, E. faecium bacteraemia and not receiving active antimicrobial therapy. No statistically significant association between high-level gentamicin resistance and mortality was demonstrated on multivariate analysis. Enterococcal bacteraemia occurs in a co-morbid, healthcare-exposed population. Associated mortality is high, and is associated with severe underlying disease, E. faecium bacteraemia and treatment factors.

Keywords

Amoxycillin Attributable Mortality Residential Care Facility Invasive Device Enterococcal Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors wish to acknowledge Graham McBride for his assistance with the statistical analysis, and the staff of the microbiology laboratory at LabPlus, the laboratory serving Auckland City Hospital (ACH), New Zealand.

Conflicts of interest

Stephen McBride: no conflicts of interest.

Arlo Upton: no conflicts of interest.

Sally Roberts: no conflicts of interest.

Funding received

No funding was received for this work.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Microbiology DepartmentJohn Radcliffe HospitalOxfordUK
  2. 2.Middlemore HospitalAucklandNew Zealand
  3. 3.LabPlus, Auckland City HospitalAucklandNew Zealand

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