Prospective evaluation of virulence factors of enterococci isolated from patients with peritonitis: impact on outcome.
The objective of this study was to evaluate the prevalence of 4 virulence factors (VFs) of enterococci (cytolysin [cyl], gelatinase [gel], aggregation substance [agg], and enterococcal surface protein [esp]) and their relationship to outcome in patients with generalized peritonitis in a prospective cohort study. VF expression in each strain was assessed by polymerase chain reaction assay with specific primers. Outcome of the patients was recorded. Ninety-nine strains of Enterococcus were obtained from the peritoneal fluid of 81 patients. Fifty-eight patients had at least 1 strain bearing [cyl] (13.1% of the strains), [gel] (50.5% of the strains), [agg] (40.4% of the strains), and [esp] (34.3% of the strains). The presence of VF of Enterococcus was independently associated with mortality: odds ratio, 5.5; 95% confidence interval, 1.3-28.1. In conclusion, VF accounted for 72% of the patients with enterococci isolated from the peritoneal fluid and was independently associated with mortality in severe peritonitis.
Dupont
Hervé
H
Surgical Critical Care Unit, University Hospital Bichat-Claude Bernard, 75018 Paris, France. dupont.herve@chu-amiens.fr
Vael
Carl
C
Muller-Serieys
Claudette
C
Chosidow
Denis
D
Mantz
Jean
J
Marmuse
Jean-Pierre
JP
Andremont
Antoine
A
Goossens
Hermann
H
Desmonts
Jean-Marie
JM
D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000032:analysis / Q000235:genetics; D001430:Bacteriocins / Q000032:analysis / Q000235:genetics; D016983:Enterococcus / Q000302:isolation & purification* / Q000502:physiology*; D005260:Female; D018093:Gelatinases / Q000032:analysis / Q000235:genetics; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D016896:Treatment Outcome; D037521:Virulence Factors / Q000032:analysis* / Q000235:genetics*
D001426:Bacterial Proteins; D001430:Bacteriocins; D008565:Membrane Proteins; D037521:Virulence Factors; C065937:aggregation substance, Enterococcus faecalis; C120351:cytolysin, Enterococcus faecalis; C116707:enterococcal surface protein, esp; D018093:Gelatinases