title: Bacteremia caused by non-faecalis and non-faecium enterococcus species at a Medical center in Taiwan, 2000 to 2008.
abstract: OBJECTIVE
  Human infections due to non-faecalis and non-faecium Enterococcus species are emerging but data on the characteristics of these infections are limited.
  
  
  METHODS
  We retrospectively reviewed the computerized database of the bacteriology laboratory at National Taiwan University Hospital from January 2000 through December 2008 to identify patients with non-faecalis and non-faecium enterococcal bacteremia.
  
  
  RESULTS
  Enterococcal bacteremia was diagnosed in 1887 patients during the study period and was caused by non-faecalis and non-faecium enterococci in 182 (9.6%) of these patients. The causative organisms included Enterococcus casseliflavus (n = 59, 3.1%), Enterococcus gallinarum (n = 58, 3.0%), Enterococcus avium (n = 45, 2.4%), Enterococcus hirae (n = 9, 0.5%), Enterococcus raffinosus (n = 9, 0.5%), Enterococcus durans (n = 2, 0.1%), Enterococcus cecorum (n = 2, 0.1%), and Enterococcus canintestini (n = 1, 0.5%). A commercially-available phenotypic identification system misidentified six isolates based upon sequence analysis of 16S and groESL genes. Among the 182 patients, 74 (40.7%) had catheter-associated bloodstream infection and 69 (37.9%) presented with biliary tract infection. Healthcare-associated enterococcal bacteremia comprised 99 (54.4%) episodes and a polymicrobial etiology was found in 106 (58.2%) episodes. The clinical manifestations varied between the infecting Enterococcus species. Multivariate logistic regression showed that immunocompromised status is the only risk factor for the all cause mortality.
  
  
  CONCLUSIONS
  Non-faecalis and non-faecium Enterococcus species can cause protean manifestations which vary with the infecting Enterococcus species. Misidentification of unusual enterococcal species might occur by the commercial identification methods and accurate identification with molecular methods is required.
authors.affiliation: Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Tainan.
authors.forename: Che-Kim
authors.initials: CK
authors.lastname: Tan
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Lai
authors.forename: Jen-Yu
authors.initials: JY
authors.lastname: Wang
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
authors.forename: Chun-Hsing
authors.initials: CH
authors.lastname: Liao
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Huang
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Wang
authors.forename: Hen-I
authors.initials: HI
authors.lastname: Lin
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D015373:Bacterial Typing Techniques; D001431:Bacteriological Techniques / Q000379:methods; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D016983:Enterococcus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D013624:Taiwan / Q000453:epidemiology
chemical_list: D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S