[Enterococcus faecalis bacteremia].
OBJECTIVE
Analysis of Enterococcus faecalis bacteremia epidemiological, clinical, microbiological and prognostic characteristics.


METHODS
Retrospective analysis of clinical records of patients with E. faecalis bacteremia throughout 7 years (January 1995-December 2001).


RESULTS
95 episodes of bacteremia were documented, 83.2% with nosocomial origin, 85.3% associated to previous invasive procedures and 9.5% in neonates. 57.9% patients suffered an underlying disease and 41.1% had received previously broad-spectrum antibiotics without activity against enterococcus. 32.6% bacteremia episodes was considered primary and, in the rest, the most frequent associated sources of infection were cardiovascular, intra-abdominal, urogenital, and lung. The resistance study showed a single case of resistance to ampicillin and none to glucopeptides. Global mortality was 23.9%, although only in 9.9% was directly attributable to bacteremia. Inadecuate treatment and mechanical ventilation were factors of poor prognosis in the multivariate analysis.


CONCLUSIONS
E. faecalis bacteremia is in our environment essentially a hospital-acquired infection in patients with severe underlying diseases, subject to invasive procedures, and previously treated with wide spectrum antibiotherapy. Ampicillin continues to be the treatment of choice. Inappropriateness of the initial empirical antibiotic treatment and mechanical ventilation are factors of poor prognosis.
Fernández Fernández
F J
FJ
Servicio de Medicina Interna, Complexo Hospitalario Xeral-Cíes, Vigo. Pontevedra, Spain.
de la Fuente Aguado
J
J
Rubianes González
M
M
Pérez Fernández
S
S
Alvarez Fernández
M
M
Nodar Germiñas
A
A
Sopeña Pérez-Argüelles
B
B
Martínez Vázquez
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology