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Enterococcal Infections: An Increasing Problem in Hospitalized Patients

Published online by Cambridge University Press:  21 June 2016

Margaret S. Terpenning
Affiliation:
Divisions of Infectious Diseases and Geriatrics, Department of Internal Medicine, Veterans Administration Medical Center, and The University of Michigan Medical School, Ann Arbor, Michigan
Marcus J. Zervos
Affiliation:
Divisions of Infectious Diseases and Geriatrics, Department of Internal Medicine, Veterans Administration Medical Center, and The University of Michigan Medical School, Ann Arbor, Michigan
Dennis R. Schaberg
Affiliation:
Divisions of Infectious Diseases and Geriatrics, Department of Internal Medicine, Veterans Administration Medical Center, and The University of Michigan Medical School, Ann Arbor, Michigan
Carol A. Kauffman*
Affiliation:
Divisions of Infectious Diseases and Geriatrics, Department of Internal Medicine, Veterans Administration Medical Center, and The University of Michigan Medical School, Ann Arbor, Michigan
*
Veterans Administration Medical Center, 2215 Fuller Road, Ann Arbor, MI 48105

Abstract

We studied 157 episodes of infection or colonization with enterococci in 122 patients over a six-month period. One hundred twelve episodes (71.3%) occurred in patients over age 60 years. The most common sites for isolation of enterococci were the urinary tract, and bone and soft tissue. Nosocomial acquisition of enterococci occurred in 74.7% of all infections, and an additional 21% of episodes occurred in patients who had been transferred from another hospital or were regularly seen in the clinic. The overall mortality was 19.6%; 71.4% of those with bacteremia died. Enterococci appear to be significant pathogens, especially in older men in veterans' acute care hospitals and nursing home care units.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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References

1. Centers for Disease Control: National nosocomial infections study reports. Atlanta, Centers for Disease Control, 1983.Google Scholar
2. Garrison, RN, Fry, DE, Berberich, S, et al: Enterococcal bacteremia: Clinical implications and determinants of death. Ann Surg 1982; 196:4347.CrossRefGoogle ScholarPubMed
3. Malone, DA, Wagner, RA, Myers, JP, et al: Enterococcal bacteremia in two large community teaching hospitals. Am J Med 1986; 81:601606.CrossRefGoogle ScholarPubMed
4. Morrison, AJ, Wenzel, RP: Nosocomial urinary tract infections due to enterococcus. Ten years experience at a university hospital. Arch Intern Med 1986; 146:15491551.CrossRefGoogle ScholarPubMed
5. Shlaes, DM, Levy, J, Wolinsky, E: Enterococcal bacteremia without endocarditis. Arch Intern Med 1981; 141:578581.CrossRefGoogle ScholarPubMed
6. Hoffman, SA, Moellering, RC Jr: The enterococcus: Putting the bug in our ears. Ann Intern Med 1987; 106:757761.CrossRefGoogle Scholar
7. Moellering, RC: Enterococcal infections in patients treated with moxalactam. Rev Infect Dis 1982; 4:S708S711.CrossRefGoogle ScholarPubMed
8. Centers for Disease Control: Guidelines for determining presence and classification of infections. Outline for surveillance and control of nosocomial infections. US Public Health Service, 1976.Google Scholar
9. Facklam, RR, Carey, RB: Streptococci and aerococci, in Lennette, EH, Balows, A, Hausler, WJ Jr. et al (eds): Manual of Clinical Microbiology, ed 4. Washington, DC, American Society for Microbiology, 1985, pp 154175.Google Scholar
10. Zervos, MJ, Patterson, JE, Edberg, S, et al: Single-concentration broth microdilution test for detection of high-level aminoglycoside resistance in enterococci. J Clin Microbiol 1987; 25:24432444.CrossRefGoogle ScholarPubMed
11. Gross, PA, Harkavy, LM, Barden, GE, et al: The epidemiology of nosocomial enterococcal urinary tract infection. Am J Med Sci 1976; 272:7581.CrossRefGoogle ScholarPubMed
12. Zervos, MJ, Dembinski, S, Mikesell, T, et al: High-level resistance to gentamicin in Streptococcus faecalis: Risk factors and evidence for exogenous acquisition of infection. J Infect Dis 1986; 153:10751082.CrossRefGoogle ScholarPubMed
13. Zervos, MJ, Kauffman, CA, Therasse, PM, et al: Epidemiology of nosocomial infection caused by gentamicin resistant Streptococcus faecalis . Ann Intern Med 1987; 106:687691.CrossRefGoogle Scholar
14. Zervos, MJ, Terpenning, MS, Schaberg, DR, et al: High-level aminoglycoside-resistant enterococci: Colonization of nursing home and acute care hospital patients. Arch Intern Med 1987: 147:15911594.CrossRefGoogle ScholarPubMed
15. Berk, SL, Verghese, A, Holtsclaw, SA, et al: Enterococcal pneumonia. Occurrence in patients receiving broad-spectrum antibiotic regimens and enteral feeding. Am J Med 1983; 74:153154.CrossRefGoogle ScholarPubMed
16. Courvalin, P, Carlier, C, Collatz, E: Plasmid-mediated resistance to aminocyclitol antibiotics in group D streptococci. J Bacteriol 1980; 143:541551.CrossRefGoogle ScholarPubMed
17. Horodniceanu, T, Bougueleret, L, El-Solh, N, et al: High-level plasmid-borne resistance to gentamicin in Streptococcus faecalis sub zymogenes . Antimicrob Agents Chemother 1979; 16:686689.CrossRefGoogle Scholar
18. Kathpatia, S, Lewandowski, R, Jackson, GG: Resistance to all aminoglycoside antibiotics in enterococcal endocarditis. Clin Res 1984; 32:372A.Google Scholar
19. Mederski-Samoraj, BD. Murray, BE: High-level resistance to gentamicin in clinical isolates of enterococci. J Infect Dis 1983; 147:752757.CrossRefGoogle ScholarPubMed
20. Patterson, JE, Masecar, HI. Kauffman, CA, et al: Gentamicin resistance plasmids of enterococci from diverse geographic areas are heterogeneous. J Infect Dis 1988; 158:212216.CrossRefGoogle ScholarPubMed