Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009: A population-based cohort study

M. Pinholt*, C. Østergaard, M. Arpi, N. E. Bruun, H. C. Schønheyder, K. O. Gradel, M. Søgaard, J. D. Knudsen

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    Enterococci currently account for approximately 10% of all bacteraemias, reflecting remarkable changes in their epidemiology. However, population-based data of enterococcal bacteraemia are scarce. A population-based cohort study comprised all patients with a first episode of Enterococcus faecalis or Enterococcus faecium bacteraemia in two Danish regions during 2006-2009. We used data collected prospectively during clinical microbiological counselling and hospital registry data. We determined the incidence of mono- and polymicrobial bacteraemia and assessed clinical and microbiological characteristics as predictors of 30-day mortality in monomicrobial bacteraemia by logistic regression analysis. We identified 1145 bacteraemic patients, 700 (61%) of whom had monomicrobial bacteraemia. The incidence was 19.6/100 000 person-years (13.0/100 000 person-years for E. faecalis and 6.6/100 000 person-years for E. faecium). The majority of bacteraemias were hospital-acquired (E. faecalis, 45.7%; E. faecium, 85.2%). Urinary tract and intra-abdominal infections were the predominant foci for the two species, respectively. Infective endocarditis (IE) accounted for 25% of patients with community-acquired E. faecalis bacteraemia. Thirty-day mortality was 21.4% in patients with E. faecalis and 34.6% in patients with E. faecium. Predictors of 30-day mortality included age, co-morbidity and hospital-acquired bacteraemia. In addition, intra-abdominal infection, unknown focus and high-level gentamicin resistance were predictors of mortality in E. faecalis patients. E. faecium was associated with increased risk of mortality compared with E. faecalis. The study emphasizes the importance of enterococci both in terms of incidence and prognosis. The frequency of IE in patients with E. faecalis bacteraemia emphasizes the importance of echocardiography, especially in community-acquired cases.

    OriginalsprogEngelsk
    Sider (fra-til)145-151
    Antal sider7
    TidsskriftClinical Microbiology and Infection
    Vol/bind20
    Udgave nummer2
    DOI
    StatusUdgivet - feb. 2014

    Fingeraftryk

    Udforsk hvilke forskningsemner 'Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009: A population-based cohort study' indeholder.

    Citationsformater