[An analysis of 182 enterococcal bloodstream infections: epidemiology, microbiology, and outcome].
BACKGROUND
Enterococcal bloodstream infections have acquired considerable importance in recent years, mainly because of the increasing number of cases that occur during hospital admission.


METHODS
Retrospective study of the clinical records of patients diagnosed with enterococcal bacteremia and hospitalized over a 12-year period (January 1994-April 2006), analyzing epidemiological, clinical and microbiological characteristics, outcome and prognostic factors.


RESULTS
A total of 182 episodes of bacteremia were recorded; 68% of them were nosocomial infections, accounting for 5% of the in-hospital bacteremia episodes in this period. The most frequent sources of infection were urinary tract (29%), cardiovascular (25%), intra-abdominal (21%) and primary bacteremia (12%). Associated comorbid conditions were present in 85% of patients, mainly neoplasms (33%). Enterococcus faecalis was responsible for 70% of cases, E. faecium 22%, and other species of enterococci 8%. Twenty percent were polymicrobial bacteremia. Antibiotic resistance was documented in 23% of the strains: 14% ampicillin, 8% gentamicin, 3% ampicillin and gentamicin, and 0.5% vancomycin. Overall mortality was 31%. Polymicrobial bacteremia and comorbidity were associated with a poor prognosis.


CONCLUSIONS
In our hospital, Enterococcus is the fifth most frequent cause of nosocomial bacteremia. E. faecium is characterized by a high incidence (more than 50% of cases) of ampicillin resistance.
Martínez-Odriozola
Pedro
P
Servicio de Medicina Interna. Hospital de Basurto. Bilbao. España. pmodrioz@hbas.osakidetza.net
Muñoz-Sánchez
Josefa
J
Gutiérrez-Macías
Alfonso
A
Arriola-Martínez
Paula
P
Montero-Aparicio
Esperanza
E
Ezpeleta-Baquedano
Carmen
C
Cisterna-Cáncer
Ramón
R
Miguel de la Villa
Felipe
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000302:isolation & purification* / Q000472:pathogenicity; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology