title: A 10-year profile of enterococcal bloodstream infections at a tertiary-care hospital in Japan.
abstract: OBJECTIVE
  The first aim of this study is to characterize the epidemiology of enterococcal bloodstream infections (BSIs) at a Japanese tertiary-care hospital. The second aim is to identify predictive factors for 30-day mortality.
  
  
  METHODS
  We conducted a single center retrospective observational study. All patients with enterococcal BSI between 2005 and 2014 were enrolled. Univariate and multivariate analysis were performed to evaluate predictive factors for 30-day mortality.
  
  
  RESULTS
  A total of 410 patients with enterococcal BSI were enrolled. Enterococcus faecalis was identified in 200 patients (48.8%) and Enterococcus faecium in 124 patients (30.2%). Isolates were susceptible to ampicillin and vancomycin (67.3% and 97.8%, respectively). Isolates that were not susceptible to vancomycin were either Enterococcus casseliflavus or Enterococcus gallinarum. All strains of E. faecalis and 10.8% of E. faecium strains were susceptible to ampicillin. Thirty-day mortality was 24.8%. Predictive factors for 30-day mortality were Charlson Comorbidity Index (CCI) 1-2 (adjusted odds ratio [OR] 6.07, 95% confidence interval [CI]: 1.22-30.2), CCI 3-4 (adjusted OR 8.79, 95% CI: 1.70-45.4), CCI ≥5 (adjusted OR 17.6, 95% CI: 3.52-88.2), E. faecium bacteremia (adjusted OR 2.19, 95% CI: 1.27-3.76), Pitt Bacteremia Score (PBS) ≥5 (adjusted OR 15.1, 95% CI: 6.41-35.6), and source control (adjusted OR 0.39, 95% CI: 0.22-0.72).
  
  
  CONCLUSIONS
  Vancomycin-resistant strains of E. faecalis and E. faecium were not seen in this cohort. In addition, all strains of E. faecalis and 10.8% of E. faecium strains were susceptible to ampicillin. Predictive factors for 30-day mortality were CCI score, E. faecium bacteremia, PBS score, and source control.
authors.affiliation: Department of Infectious Diseases, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba 2968602, Japan. Electronic address: tasika_hiroyuki_suzuki@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Infectious Diseases, Narita Red Cross Hospital, 90-1, Iidacho, Narita, Chiba 2868523, Japan. Electronic address: ryota510@hotmail.com.
authors.forename: Ryota
authors.initials: R
authors.lastname: Hase
authors.affiliation: Department of Laboratory Medicine, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba 2968602, Japan. Electronic address: otsuka.yoshihito@kameda.jp.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Otsuka
authors.affiliation: Department of Infectious Diseases, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba 2968602, Japan. Electronic address: nhosokawa.kameda@gmail.com.
authors.forename: Naoto
authors.initials: N
authors.lastname: Hosokawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality*; D013293:Enterococcus faecalis / Q000187:drug effects; D016984:Enterococcus faecium / Q000187:drug effects; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteremia; Enterococcus faecalis; Enterococcus faecium