title: Enterococcal Bacteremia is Associated with Prolonged Stay in the Medical Intensive Care Unit.
abstract: BACKGROUND
  Although enterococci are relatively common nosocomial pathogens in surgical intensive care units (ICUs), their significance in blood cultures from patients in the medical ICU is unclear.
  
  
  METHODS
  In this retrospective study spanning 2 years, the clinical and microbiological characteristics of enterococcal bacteremia among medical ICU patients were evaluated.
  
  
  RESULTS
  Of 1325 admissions, 35 with enterococcal bacteremia accounted for 14.8% of positive blood cultures. They were significantly older (P=0.03) and had various co-morbidities. Most had vascular (96.9%) and urinary (85.3%) catheters, and 67.7% were mechanically ventilated. In addition to blood, enterococci were isolated from vascular catheters (8.6%) and other sites (20%), while no focus was identified in 77% of patients. Prior use of broad-spectrum antimicrobials was nearly universal. All isolates tested were sensitive to vancomycin and linezolid. Resistance to ampicillin and gentamicin were 44.7% and 52.6%, respectively. Compared with other medical ICU patients, patients with enterococcal bacteremia had a longer ICU stay (P<0.0001) and a trend toward higher ICU mortality (P=0.08).
  
  
  CONCLUSIONS
  Enterococcal bacteremia is an important nosocomial infection in the medical ICU, with a predilection for older patients with multiple comorbidities. Its occurrence is associated with a significantly longer ICU stay and a trend to a higher mortality. The choice of antibiotics should be dictated by local susceptibility data.
authors.affiliation: Department of Medicine, Christian Medical College and Hospital, Vellore, India.
authors.forename: Viju
authors.initials: V
authors.lastname: Moses
authors.forename: Jayakumar
authors.initials: J
authors.lastname: Jerobin
authors.forename: Anupama
authors.initials: A
authors.lastname: Nair
authors.forename: Sowmya
authors.initials: S
authors.lastname: Sathyendara
authors.forename: Veeraraghavan
authors.initials: V
authors.lastname: Balaji
authors.forename: Ige Abraham
authors.initials: IA
authors.lastname: George
authors.forename: John Victor
authors.initials: JV
authors.lastname: Peter