Multicenter study evaluating the role of enterococci in secondary bacterial peritonitis.
A 1-year prospective multicenter study was performed to explore the significance of the presence of enterococci in cultures of peritoneal fluid from patients with secondary bacterial peritonitis in seven Spanish hospitals. The clinical records of patients with positive peritoneal fluid cultures were reviewed and distributed into cases (patients with cultures yielding enterococci) and controls (patients with cultures not yielding enterococci). Of a total of 158 records, 38 (24.1%) were cases and 120 (75.9%) were controls. The percentages or the scores (cases versus controls) for the variables included in the multivariate analysis were as follows: age of >50 years, 89.5% versus 68.3%; malignancy, 39.5% versus 18.3%; chronic obstructive pulmonary disease (COPD), 15.8% versus 4.2%; postoperative peritonitis, 55.3% versus 30.1%; nosocomial onset, 57.9% versus 34.2%; a higher Charlson comorbidity index, 3.29 +/- 3.38 versus 1.84 +/- 2.31; APACHE II score, 10.71 +/- 4.37 versus 8.76 +/- 5.49; ultimately or rapidly fatal disease, 63.2% versus 34.8%; need for surgical reintervention, 36.1% versus 15.1%; and admission to an intensive care unit, 45.9% versus 30.8%. In the multivariate analysis, enterococci were associated only with postoperative peritonitis (P = 0.009; odds ratio [OR] = 5.0; 95% confidence interval [CI] = 1.49 to 16.80), a higher Charlson comorbidity index (P = 0.002; OR = 1.30; 95% CI = 1.11 to 1.54), and COPD (P = 0.046; OR = 6.50; 95% CI = 1.04 to 40.73). The results of this study showed that enterococci were associated with comorbidity. An association with mortality could not be demonstrated.
Cercenado
Emilia
E
Microbiology Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo 46, Madrid 28007, Spain.
Torroba
Luis
L
Cantón
Rafael
R
Martínez-Martínez
Luis
L
Chaves
Fernando
F
García-Rodríguez
Jose Angel
JA
Lopez-Garcia
Carmen
C
Aguilar
Lorenzo
L
García-Rey
César
C
García-Escribano
Nuria
N
Bouza
Emilio
E
D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology; D015897:Comorbidity; D016983:Enterococcus / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology