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J Glob Infect Dis. 2012 Jan;4(1):26-30. doi: 10.4103/0974-777X.93758.

Enterococcal Bacteremia is Associated with Prolonged Stay in the Medical Intensive Care Unit.

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  • 1Department of Medicine, Christian Medical College and Hospital, Vellore, India.

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.

MATERIALS AND 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.

KEYWORDS:

Bacteremia; Duration; Enterococcal; Medical intensive care unit; Mortality

PMID:
22529624
PMCID:
PMC3326954
DOI:
10.4103/0974-777X.93758
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