title: Enterococcal bacteraemia: epidemiological, microbiological, clinical and prognostic characteristics, and the impact of high level gentamicin resistance.
abstract: Enterococci are increasingly common nosocomial pathogens that can cause serious infections and often acquire antibiotic resistance. This study focused on the epidemiological, microbiological and clinical characteristics of enterococcal bacteraemia with special attention to the impact of high level gentamicin resistance (HLGR) on prognosis. 117 cases of enterococcal bacteraemia constituted 8% of all bacteraemic episodes during the y 2002. The most common source of infection was the urinary tract, more than half of the episodes were polymicrobial and the vast majority of cases was healthcare-associated. 50 of 117 isolates (43%) were resistant to gentamicin. Infection-related mortality (22 of 117, 19%) was associated with 2 independent variables in multivariate analysis: severity-of-illness score (OR=39.6, p<0.00001) and HLGR (OR=6.4, p=0.006). It was concluded that HLGR adversely affects the outcome of bacteraemic enterococcal infection.
authors.affiliation: Infectious Diseases Unit, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel.
authors.forename: Hila
authors.initials: H
authors.lastname: Shaked
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.forename: David
authors.initials: D
authors.lastname: Schwartz
authors.forename: Yardena
authors.initials: Y
authors.lastname: Siegman-Igra
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D016983:Enterococcus / Q000187:drug effects* / Q000472:pathogenicity; D005260:Female; D005839:Gentamicins / Q000494:pharmacology*; D006785:Hospitals, University; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins