title: [Hospital infection caused by enterococci. The previous use of antibiotics as risk factors in a case-control study].
abstract: BACKGROUND
  Nosocomial infection by enterococci is of growing importance and recognition. The risk factors, morbidity and prognosis of the same were investigated by a case and control study in a third level university hospital.
  
  
  METHODS
  One hundred patients with nosocomial infection by enterococci were compared with 100 randomly selected control patients with non enterococcic nosocomial infection. Cases and controls were taken from a series of 10,926 patients examined in search of nosocomial infection by successive cut offs of prevalence.
  
  
  RESULTS
  The prevalence of nosocomial infection by enterococci was found to be 9.9 per 1,000 admissions. Analysis among cases and controls by the odds ratio indicated a positive association for nosocomial infection by enterococci for the following risk factors: male sex (1.8), receipt of intensive care (3.6), predisposing diseases (3.1), urinary catheter (3), abdominal-genital surgery (2.4) or nephro-urologic surgery (4.6), other previous infections (1.9) and previous exposure to antibiotics (3.7), mainly aminoglucosides (4.2). Urinary infections and those of the surgical wound predominated, 15 patients had bacteremia, with mortality related with infection being 2%, preinfection hospital stay was 34.7 days and the mean stay was of 8.3 days but these data were not statistically different in the control group. The enterococcic infections were most frequently polymicrobian (odds ratio 5.5) received worse antibiotic coverage (5.1) and presented greater number of therapeutic failures or recurrences (2.5).
  
  
  CONCLUSIONS
  Nosocomial infection by enterococci is relatively frequent and virulent. The risk factors identified in this study are in agreement with those found in most series. The previous use of aminoglucosides was specially capable of selecting enterococci but only 13% demonstrated high level resistance to gentamicin.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Central de Asturias, Universidad de Oviedo.
authors.forename: J A
authors.initials: JA
authors.lastname: Carton
authors.forename: J A
authors.initials: JA
authors.lastname: Maradona
authors.forename: V
authors.initials: V
authors.lastname: Asensi
authors.forename: F
authors.initials: F
authors.lastname: Pérez González
authors.forename: B
authors.initials: B
authors.lastname: López Ponga
authors.forename: P
authors.initials: P
authors.lastname: de la Iglesia
authors.forename: G
authors.initials: G
authors.lastname: Pérez del Molino
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D016983:Enterococcus; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D011292:Premedication; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Infección hospitalaria por enterococos. El uso previo de antibióticos como factor de riesgo a través de un estudio de casos y controles.