Are enterococcal bloodstream infections an independent risk factor for a poorer 5-year survival or just a marker for severity of illness?-The Munich multicentric enterococci cohort

Microbiol Spectr. 2023 Dec 12;11(6):e0258523. doi: 10.1128/spectrum.02585-23. Epub 2023 Oct 4.

Abstract

The present study provides a substantial contribution to literature, showing that patients with enterococcal bloodstream infections (BSI) have a lower survival rate than those with Escherichia coli (E. coli) bloodstream infections after adjusting for 17 limiting prognostic factors and excluding patients with a limited life expectancy [metastatic tumor disease, Charlson Comorbidity Index (CCI) (greater than or equal to) 5]. This difference in the 5-year long-term survival was mainly driven by Enterococcus faecium (ECFM) bloodstream infections, with vancomycin resistance not being a significant contributing factor. Our findings imply that E. faecium bloodstream infections seem to be an independent risk factor for poor long-term outcomes. As such, future research should confirm this relationship and prioritize investigating its causality through prospective studies.

Keywords: 5-year survival; Enterococcus faecium; disease severity; enteroccocal bloodstream infections; vancomycin resistant Entercoccus faecium.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / epidemiology
  • Enterococcus
  • Escherichia coli
  • Escherichia coli Infections* / epidemiology
  • Gram-Positive Bacterial Infections* / diagnosis
  • Gram-Positive Bacterial Infections* / epidemiology
  • Humans
  • Patient Acuity
  • Prospective Studies
  • Risk Factors
  • Sepsis*

Substances

  • Anti-Bacterial Agents