Nosocomial Enterococcal Bacteremia:Predictors of Resistance and Mortality

Abstract

Objectives: This study aims to identify the risk factors associated with 14-day mortality in nosocomial Enterococcibacteremia.Methods: This retrospective study was conducted in a tertiary training hospital. Patients aged 16 or older, with nosoco-mial bacteremia due to Enterococci between January 2012 and January 2018 were included. Analyses were performed using SPSS version 21. Pearson’s chi-square, and Fisher’s Exact tests were used for the comparison of categorical data. Parameters found to be statistically significant in univariate analyses were further tested with multivariate logistic re-gression to predict the risk of mortality. Statistical significance is interpreted as p-values lower than 0.05.Results: The mean age in our study was 64.82±16.76. Patients were diagnosed in intensive care unit (44%), internal medicine wards (41.3%) or surgical wards (14.7%). Reasons of admittance included medical problems (52.7%), surgery (14.1%), cerebrovascular occlusion (12.5%), burns (7.1%) and community acquired infections (6.5%). We found that increase in both Charlson and Pitt bacteremia scores; the presence of neutropenia, severe sepsis, septic shock, or other concurrent infections significantly increased the risk of death. Gentamicin sensitivity yielded more favorable therapeu-tic outcomes regarding mortality.Conclusion: Mortality is higher in patients with higher Charlson comorbidity indices and Pitt bacteremia scores, in neutropenic cases, and patients with concomitant infections and sepsis. Interestingly, mortality in gentamicin-sensitive cases is significantly lower.