Comparative Study of Bacteremias Caused by Enterococcus spp. with and without High-Level Resistance to Gentamicin
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1998Referencia bibliográfica
JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 1998, p. 520–525
Resumen
A prospective, multicenter study was carried out over a period of 10 months. All patients with clinically
significant bacteremia caused by Enterococcus spp. were included. The epidemiological, microbiological, clinical,
and prognostic features and the relationship of these features to the presence of high-level resistance to
gentamicin (HLRG) were studied. Ninety-three patients with enterococcal bacteremia were included, and 31 of
these cases were caused by HLRG (33%). The multivariate analysis selected chronic renal failure, intensive
care unit stay, previous use of antimicrobial agents, and Enterococcus faecalis species as the independent risk
factors that influenced the development of HLRG. The strains with HLRG showed lower levels of susceptibility
to penicillin and ciprofloxacin. Clinical features (except for chronic renal failure) were similar in both groups
of patients. HLRG did not influence the prognosis for patients with enterococcal bacteremia in terms of either
the crude mortality rate (29% for patients with bacteremia caused by enterococci with HLRG and 28% for
patients not infected with strains with HLRG) or the hospital stay after the acquisition of enterococcal
bacteremia. Hemodynamic compromise, inappropriate antimicrobial therapy, and mechanical ventilation were
revealed in the multivariate analysis to be the independent risk factors for mortality. Prolonged hospitalization
was associated with the nosocomial acquisition of bacteremia and polymicrobial infections.