Data/hora: 04/06/2024 15:19:07

Provedor de dados: | 56
País: | Brazil
Título: | Clinical, epidemiological, and microbiological characteristics of bacteremia caused by high-level gentamicin-resistant Enterococcus faecalis
Autores: | Vigani,A.G.; Macedo de Oliveira,A.; Bratfich,O.J.; Stucchi,R.S.B.; Moretti,M.L.
Data: | 2008-10-01
Ano: | 2008
Palavras-chave: | Enterococcus faecalis; Bacteremia; High-level gentamicin resistance; Infection control; Enterococcus faecalis genotyping.
Resumo: | 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 São 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 &lt; 0.05). Multivariate analysis indicated that older age, hematological malignancy, and previous use of vancomycin were independently associated with HLGR (P &lt; 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.
Tipo: | Info:eu-repo/semantics/other
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2008001000010
Editor: | Associação Brasileira de Divulgação Científica
Relação: | 10.1590/S0100-879X2008001000010
Formato: | text/html
Fonte: | Brazilian Journal of Medical and Biological Research  v.41 n.10 2008
Fonte: | info:eu-repo/semantics/openAccess