Impact of enterococcal urinary tract infections in immunocompromised - neoplastic patients

J BUON. 2019 Sep-Oct;24(5):1768-1775.

Abstract

Infections in immunocompromised-neoplastic patients represent a severe complication. Among bacteria, Enterococcus species constitute a common causative pathogen of urinary tract infections (UTIs), especially among hospitalized patients with or without urinary tract carcinoma, related commonly to urinary tract abnormalities, urinary catheters or prolonged antibiotic treatment. Although enterococci have been considered more commonly as colonization bacteria in the intestine than virulent agents, they are frequently implicated in UTIs. The high incidence of enterococcal UTIs is associated with several risk factors including age, female gender, previous UTI, diabetes, pregnancy, immunosuppression due to cancer development and progression, renal transplantation and spinal cord injury. Clinical manifestations are usually absent or mild in enterococcal UTIs, which may also become an important source for both bacteremia and endocarditis. Over the last years, the prevalence of multidrug resistant enterococci, particularly vancomycin-resistant E. faecium and E. faecalis has significantly risen worldwide, associated with increased morbidity, limited treatment options and increased health-care costs. In this review, the current knowledge on enterococcal UTIs epidemiology and influence in the corresponding immunocompromised patients is highlighted.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Bacterial
  • Enterococcus / drug effects
  • Enterococcus / immunology
  • Enterococcus / pathogenicity*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / immunology
  • Gram-Positive Bacterial Infections / microbiology*
  • Host-Pathogen Interactions
  • Humans
  • Immunocompromised Host*
  • Incidence
  • Neoplasms / epidemiology
  • Neoplasms / immunology*
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / immunology
  • Opportunistic Infections / microbiology*
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / immunology
  • Urinary Tract Infections / microbiology*

Substances

  • Anti-Bacterial Agents