Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

An Update to Enterococcal Bacteremia: Epidemiology, Resistance, and Outcome

Author(s): Sirous Jafari, Alireza Abdollahi, Marjan Sabahi, Mohammadreza Salehi, Ali Asadollahi-Amin, Malihe Hasannezhad and Arash Seifi*

Volume 22, Issue 2, 2022

Published on: 03 November, 2020

Article ID: e170322187568 Pages: 7

DOI: 10.2174/1871526520999201103191829

Price: $65

Abstract

Background: An increase in resistant gram-positive cocci, especially enterococci, requires an epidemiologic re-assay and its results may affect empirical treatments for these infections.

Objective: In this study, we investigated the microbial epidemiology and resistance pattern of enterococcal bacteremia.

Methods: This study was a cross-sectional study that investigated all cases of positive blood cultures with Enterococcus spp. at a tertiary referral colligates hospital in Tehran in 2018.

Results: Enterococcus spp. was isolated from blood cultures of a total of 73 patients. Most of the patients were male i.e: 42 (57.7%). The mean age of the patients was 58.8 (±18.8) years. Hospital- acquired infection was the most prevalent type of infection involving enterococcal bacteremia (80.8%) compared with community-acquired (6.7%) and the health care-associated one (12.3%). Renal failure and cancer were the most underlying disease in E. faecalis and E. faecium, respectively. Mortality for Vancomycin-resistant enterococci (VRE) was approximately two times more than the sensitive ones. Between the dead/alive groups, the following items were significantly different (P.Value<0.05): Vancomycin resistance for enterococcus isolated, immunodeficiency as an underlying disease, Mechanical ventilation, hospitalization period, and the empiric regimen.

Conclusion: Increased antibiotic-resistant strains, especially Vancomycin-resistant enterococci (VRE), pose a serious threat to the general public, especially hospitalized patients, causing an increase in mortality. Surveillance of microorganisms and antimicrobial resistance is a crucial part of an efficient health care system.

Keywords: Enterococcal bacteremia, Enterococcus faecalis, Enterococcus faecium, resistance, microorganisms, epidemiology.

Graphical Abstract

[1]
Moghimbeigi, A.; Moghimbeygi, M.; Dousti, M.; Kiani, F.; Sayehmiri, F.; Sadeghifard, N.; Nazari, A. Prevalence of vancomycin resistance among isolates of enterococci in Iran: a systematic review and meta-analysis. Adolesc. Health Med. Ther., 2018, 9, 177-188.
[http://dx.doi.org/10.2147/AHMT.S180489] [PMID: 30532606]
[2]
Armin, S; Zahedani, SS; Rahbar, M; Azimi, L Prevalence and resistance profiles of vancomycin-resistant enterococcal isolates in Iran; an eight-month report from nine major cities. Infect. Disord. Drug Targets, 2019.
[3]
Courvalin, P. Vancomycin resistance in gram-positive cocci. Clin. Infect. Dis., 2006, 42(Suppl. 1), S25-S34.
[http://dx.doi.org/10.1086/491711] [PMID: 16323116]
[4]
National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992 through June 2004. Am. J. Infect. Control, 2004, 32(8), 470-485.
[http://dx.doi.org/10.1016/j.ajic.2004.10.001] [PMID: 15573054]
[5]
Bedini, A.; Codeluppi, M.; Cocchi, S.; Guaraldi, G.; Di Benedetto, F.; Venturelli, C. Gram-positive bloodstream infections in liver transplant recipients: incidence, risk factors, and impact on survival. Transplantation proceedings. Eds. Elsevier, 2007.
[6]
Mikulska, M.; Del Bono, V.; Raiola, A.M.; Bruno, B.; Gualandi, F.; Occhini, D.; di Grazia, C.; Frassoni, F.; Bacigalupo, A.; Viscoli, C. Blood stream infections in allogeneic hematopoietic stem cell transplant recipients: reemergence of Gram-negative rods and increasing antibiotic resistance. Biol. Blood Marrow Transplant., 2009, 15(1), 47-53.
[http://dx.doi.org/10.1016/j.bbmt.2008.10.024] [PMID: 19135942]
[7]
Kajihara, T.; Nakamura, S.; Iwanaga, N.; Oshima, K.; Takazono, T.; Miyazaki, T.; Izumikawa, K.; Yanagihara, K.; Kohno, N.; Kohno, S. Clinical characteristics and risk factors of enterococcal infections in Nagasaki, Japan: a retrospective study. BMC Infect. Dis., 2015, 15, 426.
[http://dx.doi.org/10.1186/s12879-015-1175-6] [PMID: 26471715]
[8]
Webb, B.J.; Healy, R.; Majers, J.; Burr, Z.; Gazdik, M.; Lopansri, B.; Hoda, D.; Petersen, F.B.; Ford, C. Prediction of Bloodstream Infection Due to Vancomycin-Resistant Enterococcus in Patients Undergoing Leukemia Induction or Hematopoietic Stem-Cell Transplantation. Clin. Infect. Dis., 2017, 64(12), 1753-1759.
[http://dx.doi.org/10.1093/cid/cix232] [PMID: 28369204]
[9]
Caballero-Granado, F.J.; Becerril, B.; Cisneros, J.M.; Cuberos, L.; Moreno, I.; Pachón, J. Case-control study of risk factors for the development of enterococcal bacteremia. Eur. J. Clin. Microbiol. Infect. Dis., 2001, 20(2), 83-90.
[http://dx.doi.org/10.1007/s100960000429] [PMID: 11305477]
[10]
Papadimitriou-Olivgeris, M.; Drougka, E.; Fligou, F.; Kolonitsiou, F.; Liakopoulos, A.; Dodou, V.; Anastassiou, E.D.; Petinaki, E.; Marangos, M.; Filos, K.S.; Spiliopoulou, I. Risk factors for enterococcal infection and colonization by vancomycin-resistant enterococci in critically ill patients. Infection, 2014, 42(6), 1013-1022.
[http://dx.doi.org/10.1007/s15010-014-0678-1] [PMID: 25143193]
[11]
Amberpet, R.; Sistla, S.; Parija, S.C.; Thabah, M.M. Screening for Intestinal Colonization with Vancomycin Resistant Enterococci and Associated Risk Factors among Patients Admitted to an Adult Intensive Care Unit of a Large Teaching Hospital. J. Clin. Diagn. Res., 2016, 10(9), DC06-DC09.
[http://dx.doi.org/10.7860/JCDR/2016/20562.8418] [PMID: 27790430]
[12]
Al-Otaibi, F.E.; Kambal, A.M.; Baabbad, R.A. Enterococcal bacteremia in a teaching hospital in the Central region of Saudi Arabia. Saudi Med. J., 2004, 25(1), 21-25.
[PMID: 14758373]
[13]
Butler, A.M.; Olsen, M.A.; Merz, L.R.; Guth, R.M.; Woeltje, K.F.; Camins, B.C.; Fraser, V.J. Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort. Infect. Control Hosp. Epidemiol., 2010, 31(1), 28-35.
[http://dx.doi.org/10.1086/649020] [PMID: 19951200]
[14]
Moses, V.; Jerobin, J.; Nair, A.; Sathyendara, S.; Balaji, V.; George, I.A.; Peter, J.V. Enterococcal bacteremia is associated with prolonged stay in the medical intensive care unit. J. Glob. Infect. Dis., 2012, 4(1), 26-30.
[http://dx.doi.org/10.4103/0974-777X.93758] [PMID: 22529624]
[15]
McBride, S.J.; Upton, A.; Roberts, S.A. Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia-a five-year retrospective review. Eur. J. Clin. Microbiol. Infect. Dis., 2010, 29(1), 107-114.
[http://dx.doi.org/10.1007/s10096-009-0830-5] [PMID: 19916034]
[16]
Jiang, H-L.; Zhou, Z.; Wang, L-S.; Fang, Y.; Li, Y-H.; Chu, C-I. The risk factors, costs, and survival analysis of invasive VRE infections at a medical center in eastern Taiwan. International Journal of Infectious Diseases. Int. J. Infect. Dis., 2017, 54, 18-24.
[http://dx.doi.org/10.1016/j.ijid.2016.11.005] [PMID: 27836794]
[17]
Cheah, A.L.; Spelman, T.; Liew, D.; Peel, T.; Howden, B.P.; Spelman, D.; Grayson, M.L.; Nation, R.L.; Kong, D.C. Enterococcal bacteraemia: factors influencing mortality, length of stay and costs of hospitalization. Clin. Microbiol. Infect., 2013, 19(4), E181-E189.
[http://dx.doi.org/10.1111/1469-0691.12132] [PMID: 23398607]
[18]
O’Driscoll, T.; Crank, C.W. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management. Infect. Drug Resist., 2015, 8, 217-230.
[PMID: 26244026]
[19]
Hayakawa, K.; Marchaim, D.; Martin, E.T.; Tiwari, N.; Yousuf, A.; Sunkara, B.; Pulluru, H.; Kotra, H.; Hasan, A.; Bheemreddy, S.; Sheth, P.; Lee, D.W.; Kamatam, S.; Bathina, P.; Nanjireddy, P.; Chalana, I.K.; Patel, S.; Kumar, S.; Vahia, A.; Ku, K.; Yee, V.; Swan, J.; Pogue, J.M.; Lephart, P.R.; Rybak, M.J.; Kaye, K.S. Comparison of the clinical characteristics and outcomes associated with vancomycin-resistant Enterococcus faecalis and vancomycin-resistant E. faecium bacteremia. Antimicrob. Agents Chemother., 2012, 56(5), 2452-2458.
[http://dx.doi.org/10.1128/AAC.06299-11] [PMID: 22354290]
[20]
Calik, S.; Ari, A.; Okur, O.; Tosun, S.; Yis, R. Nosocomial Enterococcal Bacteremia: Predictors of Resistance and Mortality. EJMI, 2019, 3(2), 119-126.
[http://dx.doi.org/10.14744/ejmi.2019.23641]
[21]
Mohanty, S.; Kapil, A.; Das, B.K. Enterococcal bacteraemia in a tertiary care hospital of North India. J. Indian Med. Assoc., 2005, 103(1), 31-32, 34, 36-37.
[PMID: 16008327]
[22]
Suzuki, H.; Hase, R.; Otsuka, Y.; Hosokawa, N. A 10-year profile of enterococcal bloodstream infections at a tertiary-care hospital in Japan. J. Infect. Chemother., 2017, 23(6), 390-393.
[http://dx.doi.org/10.1016/j.jiac.2017.03.009] [PMID: 28385565]
[23]
Chuang, Y-C.; Lin, H-Y.; Chen, P-Y.; Lin, C-Y.; Chen, Y-C.; Wang, J-T.; Chang, S.C. Survival of patients with Vancomycin-resistant Enterococcus faecium bacteremia treated with conventional or high doses of Daptomycin or linezolid is associated with the rate of bacterial clearance. Crit. Care Med., 2018, 46(10), 1634-1642.
[http://dx.doi.org/10.1097/CCM.0000000000003264] [PMID: 29957707]
[24]
Richards, M.J.; Edwards, J.R.; Culver, D.H.; Gaynes, R.P. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect. Control Hosp. Epidemiol., 2000, 21(8), 510-515.
[http://dx.doi.org/10.1086/501795] [PMID: 10968716]
[25]
Vergis, E.N.; Hayden, M.K.; Chow, J.W.; Snydman, D.R.; Zervos, M.J.; Linden, P.K.; Wagener, M.M.; Schmitt, B.; Muder, R.R. Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia. a prospective multicenter study. Ann. Intern. Med., 2001, 135(7), 484-492.
[http://dx.doi.org/10.7326/0003-4819-135-7-200110020-00007] [PMID: 11578151]
[26]
Han, S.H.; Chin, B.S.; Lee, H.S.; Jeong, S.J.; Choi, H.K.; Kim, C.O.; Yong, D.; Choi, J.Y.; Song, Y.G.; Lee, K.; Kim, J.M. Vancomycin-resistant enterococci bacteremia: risk factors for mortality and influence of antimicrobial therapy on clinical outcome. J. Infect., 2009, 58(3), 182-190.
[http://dx.doi.org/10.1016/j.jinf.2009.01.013] [PMID: 19233476]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy