Clinical, epidemiological, and microbiological characteristics of bacteremia caused by high-level gentamicin-resistant Enterococcus faecalis

Autor: A.G. Vigani, Maria Luiza Moretti, O.J. Bratfich, A. Macedo de Oliveira, Raquel Silveira Bello Stucchi
Rok vydání: 2007
Předmět:
Male
Carbapenem
Physiology
Cephalosporin
Infection control
Bacteremia
Biochemistry
Epidemiology
Enterococcus faecalis
General Pharmacology
Toxicology and Pharmaceutics
Child
lcsh:QH301-705.5
lcsh:R5-920
biology
General Neuroscience
Mortality rate
General Medicine
Middle Aged
Anti-Bacterial Agents
Electrophoresis
Gel
Pulsed-Field
Child
Preschool
Vancomycin
Gentamicin
Female
lcsh:Medicine (General)
Brazil
medicine.drug
Adult
medicine.medical_specialty
Adolescent
medicine.drug_class
Immunology
Biophysics
Microbial Sensitivity Tests
Microbiology
Young Adult
Internal medicine
High-level gentamicin resistance
Drug Resistance
Bacterial
medicine
Humans
Gram-Positive Bacterial Infections
Aged
Enterococcus faecalis genotyping
business.industry
Infant
Newborn
Infant
Cell Biology
biology.organism_classification
medicine.disease
lcsh:Biology (General)
Gentamicins
business
Zdroj: Brazilian Journal of Medical and Biological Research, Volume: 41, Issue: 10, Pages: 890-895, Published: OCT 2008
Brazilian Journal of Medical and Biological Research, Vol 41, Iss 10, Pp 890-895 (2008)
ISSN: 1414-431X
Popis: Enterococcus spp bacteremia is associated with high mortality and the appearance of high-level gentamicin resistance (HLGR) created additional challenges for the treatment of these infections. We evaluated the epidemiological and clinical characteristics of patients with bacteremias caused by HLGR and non_HLGR Enterococcus faecalis isolates at a teaching hospital in the State of Sao Paulo, Brazil. Patients with bacteremia due to E. faecalis diagnosed between January 1999 and December 2003 were included in the study. We collected clinical, epidemiological, and microbiological data from medical records. Banked isolates were typed using pulsed-field gel electrophoresis. We identified 145 cases of E. faecalis bacteremia: 66 (45.5%) were caused by HLGR isolates and 79 (54.5%) by non_HLGR. In the univariate analysis, patients with HLGR infection were older, had higher rates of bladder catheterization, and more often had treatment with cephalosporin, quinolone, and/or carbapenem compared with patients with non_HLGR infection (P < 0.05). Multivariate analysis indicated that older age, hematological malignancy, and previous use of vancomycin were independently associated with HLGR (P < 0.05). Mortality rates were not significantly different among patients with HLGR (50%) and non_HLGR (43%) infections (P = 0.40). Of the 32 genotyped isolates, 16 were distributed into 6 main electrophoresis patterns and 16 others had distinct patterns. E. faecalis bacteremia is associated with high mortality and is frequently caused by HLGR isolates at this teaching hospital. The variability among genotyped isolates suggests that endogenous infections, rather than patient-to-patient transmission of E. faecalis, are more common at this institution.
Databáze: OpenAIRE
Externí odkaz: