Nosocomial enterococcal bacteremia: predictors of resistance and mortality
Sebnem Calik1, Alpay Ari1, Onur Okur2, Selma Tosun1, Reyhan Yis31Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Izmir Bozyaka Training and Research Hospital, Izmir, Turkey, 2Department of Anesthesiology and Reanimation, University of Health Sciences Izmir Bozyaka Training and Research Hospital, Izmir, Turkey, 3Department of Microbiology and Clinical Microbiology, University of Health Sciences Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
Objectives: This study aims to identify the risk factors associated with 14-day mortality in nosocomial Enterococci bacteremia. Methods: This retrospective study was conducted in a tertiary training hospital. Patients aged 16 or older, with nosocomial bacteremia due to Enterococci between January 2012 and January 2018 were included. Analyses were performed using SPSS version 21. Pearson’s chi-square, and Fisher’s Exact tests were used for the comparison of categorical data. Parameters found to be statistically significant in univariate analyses were further tested with multivariate logistic regression to predict the risk of mortality. Statistical significance is interpreted as p-values lower than 0.05. Results: The mean age in our study was 64.82±16.76. Patients were diagnosed in intensive care unit (44%), internal medicine wards (41.3%) or surgical wards (14.7%). Reasons of admittance included medical problems (52.7%), surgery (14.1%), cerebrovascular occlusion (12.5%), burns (7.1%) and community acquired infections (6.5%). We found that increase in both Charlson and Pitt bacteremia scores; the presence of neutropenia, severe sepsis, septic shock, or other concurrent infections significantly increased the risk of death. Gentamicin sensitivity yielded more favorable therapeutic outcomes regarding mortality. Conclusion: Mortality is higher in patients with higher Charlson comorbidity indices and Pitt bacteremia scores, in neutropenic cases, and patients with concomitant infections and sepsis. Interestingly, mortality in gentamicin-sensitive cases is significantly lower. Keywords: Enterococcus, nosocomial bacteremia, mortality
Cite This Article
Calik S, Ari A, Okur O, Tosun S, Yis R. Nosocomial enterococcal bacteremia: predictors of resistance and mortality. EJMI. 2019; 3(2): 119-126
Corresponding Author: Sebnem Calik