Previous Article | Next Article 
Journal of Clinical Microbiology, February 1998, p. 520-525, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Comparative Study of Bacteremias Caused by
Enterococcus spp. with and without High-Level Resistance
to Gentamicin
Francisco Javier
Caballero-Granado,1,*
J. M.
Cisneros,1
R.
Luque,2
M.
Torres-Tortosa,3
F.
Gamboa,4
F.
Díez,5
J. L.
Villanueva,6
R.
Pérez-Cano,7
J.
Pasquau,8
D.
Merino,9
A.
Menchero,10
D.
Mora,11
M. A.
López-Ruz,12
A.
Vergara,13 and
for the Grupo Andaluz
Para El Estudio De Las Enfermedades
Infecciosas
Unidad de Enfermedades Infecciosas, Hospital Universitario
"Virgen del Rocío,"1 and
Unidad de Enfermedades Infecciosas, Hospital "de
Valme," Seville,4
Servicio de Medicina
Interna, Hospital de Motril, Motril,2
Servicio de Medicina Interna, Hospital Clínico de
Granada,12 and
Unidad de Enfermedades
Infecciosas, Hospial Virgen de las Nieves,8
Granada,
Unidad de Enfermedades Infecciosas, Hospital "Punta
de Europa," Algeciras,3
Servicio
de Medicina Interna, Hospital "Puerta del
Mar,"7 and
Servicio de Medicina
Interna, Hospital de Puerto Real, Puerto
Real,13 Cádiz,
Servicio de
Medicina Interna, Hospital "Torrecárdenas,"
Almería,5
Unidad de Enfermedades
Infecciosas, Hospital "Reina Sofia,"
Córdoba,6
Servicio de Medicina
Interna, Hospital "Juan Ramón
Jiménez,"9 and
Servicio de
Medicina Interna, Hospital "Infanta
Elena,"10 Huelva, and
Servicio de
Medicina Interna, Hospital "Carlos Haya,"
Málaga,11 Spain
Received 23 June 1997/Returned for modification 26 September
1997/Accepted 3 November 1997
A prospective, multicenter study was carried out over a period of
10 months. All patients with clinically significant bacteremia caused
by Enterococcus spp. were included. The epidemiological, microbiological, clinical, and prognostic features and the relationship of these features to the presence of high-level resistance to gentamicin (HLRG) were studied. Ninety-three patients with enterococcal bacteremia were included, and 31 of these cases were caused by HLRG
(33%). The multivariate analysis selected chronic renal failure, intensive care unit stay, previous use of antimicrobial agents, and
Enterococcus faecalis species as the independent risk
factors that influenced the development of HLRG. The strains with HLRG showed lower levels of susceptibility to penicillin and ciprofloxacin. Clinical features (except for chronic renal failure) were similar in
both groups of patients. HLRG did not influence the prognosis for
patients with enterococcal bacteremia in terms of either the crude
mortality rate (29% for patients with bacteremia caused by enterococci
with HLRG and 28% for patients not infected with strains with HLRG) or
the hospital stay after the acquisition of enterococcal bacteremia.
Hemodynamic compromise, inappropriate antimicrobial therapy, and
mechanical ventilation were revealed in the multivariate analysis to be
the independent risk factors for mortality. Prolonged hospitalization
was associated with the nosocomial acquisition of bacteremia and
polymicrobial infections.
*
Corresponding author. Mailing address: Unidad de
Enfermedades Infecciosas, Hospital Universitario Virgen del
Rocío, Avda. Manuel Siurot s/n. 41013 Seville, Spain. Phone:
34-5-4248029. Fax: 34-5-4248111. E-mail: fjcaba{at}cica.es.
All authors are members of the Grupo Andaluz para el Estudio de las
Enfermedades Infecciosas.
Journal of Clinical Microbiology, February 1998, p. 520-525, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
This article has been cited by other articles:
-
Osmon, S., Ward, S., Fraser, V. J., Kollef, M. H.
(2004). Hospital Mortality for Patients With Bacteremia Due to Staphylococcus aureus or Pseudomonas aeruginosa. Chest
125: 607-616
[Abstract]
[Full Text]
-
Hallgren, A., Saeedi, B., Nilsson, M., Monstein, H.-J., Isaksson, B., Hanberger, H., Nilsson, L. E.
(2003). Genetic relatedness among Enterococcus faecalis with transposon-mediated high-level gentamicin resistance in Swedish intensive care units. J Antimicrob Chemother
52: 162-167
[Abstract]
[Full Text]
-
Gentry-Weeks, C., Estay, M., Loui, C., Baker, D.
(2003). Intravenous Mouse Infection Model for Studying the Pathology of Enterococcus faecalis Infections. Infect. Immun.
71: 1434-1441
[Abstract]
[Full Text]
-
Beutz, M., Sherman, G., Mayfield, J., Fraser, V. J., Kollef, M. H.
(2003). Clinical Utility of Blood Cultures Drawn From Central Vein Catheters and Peripheral Venipuncture in Critically Ill Medical Patients. Chest
123: 854-861
[Abstract]
[Full Text]
-
Hallgren, A., Abednazari, H., Ekdahl, C., Hanberger, H., Nilsson, M., Samuelsson, A., Svensson, E., Nilsson, L. E., Swedish ICU Study Group, t.
(2001). Antimicrobial susceptibility patterns of enterococci in intensive care units in Sweden evaluated by different MIC breakpoint systems. J Antimicrob Chemother
48: 53-62
[Abstract]
[Full Text]
-
Kollef, M. H., Fraser, V. J.
(2001). Antibiotic Resistance in the Intensive Care Unit. ANN INTERN MED
134: 298-314
[Abstract]
[Full Text]
-
Ibrahim, E. H., Sherman, G., Ward, S., Fraser, V. J., Kollef, M. H.
(2000). The Influence of Inadequate Antimicrobial Treatment of Bloodstream Infections on Patient Outcomes in the ICU Setting. Chest
118: 146-155
[Abstract]
[Full Text]
-
Papaparaskevas, J., Vatopoulos, A., Tassios, P. T., Avlami, A., Legakis, N. J., Kalapothaki, V.
(2000). Diversity among high-level aminoglycoside-resistant enterococci. J Antimicrob Chemother
45: 277-283
[Abstract]
[Full Text]