title: A comparison of monomicrobial versus polymicrobial Enterococcus faecalis bacteriuria in a French University Hospital.
abstract: Enterococci are of considerable relevance in the hospital setting. Their most common location is the urinary tract, where they may be responsible for both colonization and infections. They are often associated with the presence of other microorganisms. The aim was to compare monomicrobial and polymicrobial Enterococcus faecalis bacteriuria. A retrospective study was performed on the demographic, clinical, and laboratory data of 299 patients who had presented with E. faecalis bacteriuria in 2012 at a University Hospital. The bacteriuria was polymicrobial in 46.1 % of cases and in 36.4 % of cases was responsible for a urinary tract infection. Infections appeared to be more prevalent in the polymicrobial than the monomicrobial group (42 % vs 32 %, p = 0.06). Half of the patients who presented with urinary tract colonization received antibiotic treatment (54/ out of 10). A multivariate analysis adjusted for age (adjusted odds ratio [AOR] = 1.02 per year, p = 0.006), gender (AOR = 2.2, p = 0.007), and clinical classification (colonization or infection, AOR = 1.6, p = 0.091), showed that diabetes mellitus (AOR = 2.0, p = 0.04), hospital length of stay exceeding 28 days (AOR = 2.0, p = 0.03), and presence of a urinary catheter (AOR = 2.4, p = 0.001) were all factors associated with polymicrobial E. faecalis bacteriuria. A reduction in the length of hospital stay and the use of urinary catheters would appear to be required to decrease the incidence of urinary tract colonization and infections by polymicrobial E. faecalis. Improper use of antibiotics to treat urinary tract colonization remains a major concern.
authors.affiliation: Infectious and Tropical Diseases Unit, Nîmes University Hospital, Place du Professeur Robert Debré, 30029, Nîmes cedex 9, France, camillefourcade@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Fourcade
authors.forename: L
authors.initials: L
authors.lastname: Canini
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavigne
authors.forename: A
authors.initials: A
authors.lastname: Sotto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001437:Bacteriuria / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D016021:Epidemiologic Studies; D005260:Female; D005602:France / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult