ABSTRACT
INTRODUCTION: Enterococcal bloodstream infections have acquired considerable importance in recent years, mainly because of the increasing number of cases that occur during hospital admission. METHODS: Retrospective study of the clinical records of patients diagnosed with enterococcal bacteremia and hospitalized over a 12-year period (January 1994-April 2006), analyzing epidemiological, clinical and microbiological characteristics, outcome and prognostic factors. RESULTS: A total of 182 episodes of bacteremia were recorded; 68% of them were nosocomial infections, accounting for 5% of the in-hospital bacteremia episodes in this period. The most frequent sources of infection were urinary tract (29%), cardiovascular (25%), intra-abdominal (21%) and primary bacteremia (12%). Associated comorbid conditions were present in 85% of patients, mainly neoplasms (33%). Enterococcus faecalis was responsible for 70% of cases, E. faecium 22%, and other species of enterococci 8%. Twenty percent were polymicrobial bacteremia. Antibiotic resistance was documented in 23% of the strains: 14% ampicillin, 8% gentamicin, 3% ampicillin and gentamicin, and 0.5% vancomycin. Overall mortality was 31%. Polymicrobial bacteremia and comorbidity were associated with a poor prognosis. CONCLUSION: In our hospital, Enterococcus is the fifth most frequent cause of nosocomial bacteremia. E. faecium is characterized by a high incidence (more than 50% of cases) of ampicillin resistance.
Subject(s)
Bacteremia/epidemiology , Communicable Diseases, Emerging/epidemiology , Cross Infection/epidemiology , Enterococcus/isolation & purification , Gram-Positive Bacterial Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Bacteremia/microbiology , Child , Child, Preschool , Communicable Diseases, Emerging/microbiology , Comorbidity , Cross Infection/microbiology , Disease Outbreaks , Drug Resistance, Bacterial , Enterococcus/pathogenicity , Female , Gram-Positive Bacterial Infections/microbiology , Hospitals, Urban/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Spain/epidemiologyABSTRACT
Introducción. La bacteriemia por Enterococcus ha adquirido un papel relevante en los últimos años, principalmente debido al aumento del número de casos intrahospitalarios. Métodos. Estudio retrospectivo de historias clínicas de los pacientes diagnosticados de bacteriemia por enterococo e ingresados en el hospital durante un período de 12 años (enero 1994-abril 2006), analizando sus características epidemiológicas, clínicas y microbiológicas, así como la evolución y los factores pronósticos de la enfermedad. Resultados. Se registraron 182 episodios de bacteriemia, el 68% de los cuales fueron de origen nosocomial, lo que representó el 5% de las bacteriemias intrahospitalarias durante ese período. Las localizaciones más frecuentes de la infección fueron la urinaria (29%), la cardiovascular (25%), la intraabdominal (21%) y la bacteriemia primaria (12%). El 85% de los pacientes presentaron comorbilidad asociada, especialmente enfermedades neoplásicas (33%). El Enterococcus faecalis fue el responsable del 70% de los casos; E. faecium, del 22%, y otras especies de enterococo, del 8%. El 20% de las bacteriemias eran polimicrobianas. Se encontraron un 23% de cepas con resistencia a antibióticos: 14% a ampicilina, 8% a gentamicina, 3% a ampicilina y gentamicina y 0,5% a vancomicina. La mortalidad global de la serie fue del 31%. La presencia de comorbilidad y la bacteriemia polimicrobiana fueron factores de mal pronóstico. Conclusión. En nuestro hospital, el enterococo constituye el quinto patógeno más frecuente de bacteriemia intrahospitalaria, y destaca la elevada incidencia de E. faecium, resistente a ampicilina en más de la mitad de los casos (AU)
Introduction. Enterococcal bloodstream infections have acquired considerable importance in recent years, mainly because of the increasing number of cases that occur during hospital admission. Methods. Retrospective study of the clinical records of patients diagnosed with enterococcal bacteremia and hospitalized over a 12-year period (January 1994-April 2006), analyzing epidemiological, clinical and microbiological characteristics, outcome and prognostic factors. Results. A total of 182 episodes of bacteremia were recorded; 68% of them were nosocomial infections, accounting for 5% of the in-hospital bacteremia episodes in this period. The most frequent sources of infection were urinary tract (29%), cardiovascular (25%), intra-abdominal (21%) and primary bacteremia (12%). Associated comorbid conditions were present in 85% of patients, mainly neoplasms (33%). Enterococcus faecalis was responsible for 70% of cases, E. faecium 22%, and other species of enterococci 8%. Twenty percent were polymicrobial bacteremia. Antibiotic resistance was documented in 23% of the strains: 14% ampicillin, 8% gentamicin, 3% ampicillin and gentamicin, and 0.5% vancomycin. Overall mortality was 31%. Polymicrobial bacteremia and comorbidity were associated with a poor prognosis. Conclusion. In our hospital, Enterococcus is the fifth most frequent cause of nosocomial bacteremia. E. faecium is characterized by a high incidence (more than 50% of cases) of ampicillin resistance (AU)
Subject(s)
Male , Female , Humans , Enterococcus/pathogenicity , Bacteremia/epidemiology , Retrospective Studies , Cross Infection/epidemiologyABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Vena Cava Filters/adverse effects , Colic/etiology , Pulmonary Embolism/therapy , Foreign-Body Migration/diagnosisABSTRACT
No disponible
