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Risk Factors and Outcomes Associated With Non–Enterococcus faecalis, Non–Enterococcus faecium Enterococcal Bacteremia

Published online by Cambridge University Press:  21 June 2016

Marie A. de Perio ,
Paul R. Yarnold ,
John Warren  and
Gary A. Noskin
Marie A. de Perio
Affiliation:
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Paul R. Yarnold
Affiliation:
Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
John Warren
Affiliation:
Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Gary A. Noskin*
Affiliation:
Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
*
Feinberg School of Medicine, Northwestern University, 251 East Huron Street, Gaiter 3-210, Chicago, IL 60611 (gnoskin@northwestern.edu)
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Abstract

Objectives.

To compare risk factors, clinical features, and outcomes in patients with Enterococcus avium, Enterococcus casseliflavus, Enterococcus durans, Enterococcus gallinarum, and Enterococcus mundtii bacteremia (cases) with those in patients with Enterococcus faecalis bacteremia (controls).

Design.

A retrospective case-control study.

Setting.

A 725-bed, university-affiliated, academic medical center.

Patients.

The clinical microbiology database at Northwestern Memorial Hospital from January 1994 to May 2003 was searched to identify cases; each case was matched to one control on the basis of date of admission.

Results.

Thirty-three cases were identified and matched with 33 controls. The mean duration of hospital stay was longer (29.7 vs 17.2 days; P = .03) and the mean time to acquisition of bacteremia was greater (16.5 vs 6.3 days; P = .003) for cases than controls. Cases were more likely to have underlying hematologic malignancies (P < .001), to have been treated with corticosteroids (P = .02), and to be neutropenic (P = .003). Controls were more likely to have an indwelling bladder catheter (P = .01), and cases were more likely to have the gastrointestinal tract as a source of infection (P = .007) and to have concurrent cholangitis (P = .002). There were no differences in severity of illness or in mortality rates.

Conclusions.

Compared with patients with E. faecalis bacteremia, patients with non-E. faecalis, non-Enterococcus faecium enterococcal bacteremia were more likely to have a hematologic malignancy, prior treatment with corticosteroids, neutropenia, and cholangitis; longer duration of hospital stay was also identified as a clinical feature. However, non-E. faecalis, non-E. faecium species are not associated with any differences in mortality.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 1 , January 2006 , pp. 28 - 33
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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