title: [Mortality analysis of Enterococcus faecium bloodstream infection in central Taiwan].
abstract: BACKGROUND
  Bloodstream infections (BSIs) due to Enterococcus faecium (E. faecium), particularly those due to vancomycin-resistant enterococcus (VRE), are still a therapeutic challenge.
  
  
  OBJECTIVE
  To evaluate mortality from BSI due to E. faecium and VRE in central Taiwan.
  
  
  METHODS
  We retrospectively analyzed cases of significant E. faecium BSI in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2013.
  
  
  RESULTS
  Of the 76 cases, 28 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI, 10 (13.2%) cases were associated with polymicrobial bacteremia, and 29 (38.2%) cases were associated with entry via the biliary tract. VRE was observed in 18 (23.7%) cases. The 30-day mortality rate was 13.1% (10/76). Multivariate logistic regression analysis showed that bacteremia of non-biliary tract origin (OR = 8.43, 95% confidence interval (95% CI) = 1.32-54.00, p = 0.002) and ICU admission (OR = 4.2, 95% CI = 1.7-10.0, p = 0.002) were significant risk factors for 30-day mortality, whereas appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14-0.79, p = 0.013).
  
  
  CONCLUSIONS
  Our results underscore the need to assist patients admitted to ICUs with E. faecium BSIs with a non-biliary tract origin. We emphasize the use of appropriate antimicrobial therapy for E. faecium BSI with the aim to rescue more patients with these infections.
authors.forename: Chen
authors.initials: C
authors.lastname: Chang-Hua
authors.forename: Lin
authors.initials: L
authors.lastname: Li-Chen
authors.forename: Chang
authors.initials: C
authors.lastname: Yu-Jun
authors.forename: Chang
authors.initials: C
authors.lastname: Chih-Yen
mesh_terms: D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D020713:Vancomycin Resistance; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*