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BMC Infectious Diseases

, 15:426

First Online: 16 October 2015Received: 15 March 2015Accepted: 05 October 2015

Abstract

BackgroundEnterococcus spp. are particularly important etiological agents of nosocomial infections. However, the clinical characteristics of and risk factors for enterococcal infections in clinical settings are poorly understood.

MethodsThe sample included patients with Enterococcus spp. infections detected from clinical samples at Nagasaki University Hospital between 2010 and 2011 and patients with enterococcal colonization control patients. In this retrospective study, the risk factors for enterococcal infections were analyzed by comparing infected and control patients via multivariate logistic regression.

ResultsA total of 182 infected mean age, 64.6 ± 18.2 years; 114 men and 358 control patients patients with enterococcal colonization mean age, 61.6 ± 22.4 years; 183 men were included. Enterococcal infections were classified as intraperitoneal n = 87, urinary tract n = 28, or bloodstream n = 20 infections. Cancer and hematological malignancies were the most common comorbidities in enterococcal infections. Carbapenem and vancomycin were administered to 43.8 % and 57.9 % of patients infected with Enterococcus faecalis and Enterococcus faecium, respectively. No vancomycin-resistant enterococci were isolated. Multivariate analysis identified abdominal surgery odds ratio OR, 2.233; 95 % confidence interval CI, 1.529–3.261; p ≤ 0.001, structural abnormalities of the urinary tract OR, 2.086; 95 % CI, 1.088–4.000; p = 0.027, male sex OR, 1.504; 95 % CI, 1.032–2.190; p = 0.033, and hypoalbuminemia OR, 0.731; 95 % CI, 0.555–0.963; p = 0.026 as independent risk factors for enterococcal infections. Multivariate analysis showed abdominal surgery OR, 2.263; 95 % CI, 1.464–3.498; p ≤ 0.001, structural abnormalities of the urinary tract OR, 2.634; 95 % CI, 1.194–5.362; p = 0.008, and hypoalbuminemia OR, 0.668; 95 % CI, 0.490–0.911; p = 0.011 were independent risk factors for E. faecalis infection. Finally, immunosuppressive agent use OR, 3.837; 95 % CI, 1.397–10.541; p = 0.009 and in situ device use OR, 3.807; 95 % CI, 1.180–12.276; p = 0.025 were independent risk factors for E. faecium infection.

ConclusionsThese findings might inform early initiation of antimicrobial agents to improve clinical success.

KeywordsEnterococcal infection Risk factor Retrospective study Multivariate analysis AbbreviationsE. faecalisEnterococcus faecalis

E. faeciumEnterococcus faecium

SPSSStatistical Package for the Social Sciences

SDStandard deviation

OROdds ratio

CIConfidence interval

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Autor: Toshiki Kajihara - Shigeki Nakamura - Naoki Iwanaga - Kazuhiro Oshima - Takahiro Takazono - Taiga Miyazaki - Koichi Izumika

Fuente: https://link.springer.com/







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