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鹑鸡肠球菌和铅黄肠球菌所致菌血症的临床特征及转归:56例分析

Clinical features and outcomes of bacteremia caused by Enterococcus casseliflavus and Enterococcus gallinarum: analysis of 56 cases.

作者信息

Choi Sang-Ho, Lee Sang-Oh, Kim Tae Hyong, Chung Jin-Won, Choo Eun Ju, Kwak Yee Gyung, Kim Mi-Na, Kim Yang Soo, Woo Jun Hee, Ryu Jiso, Kim Nam Joong

机构信息

Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

Clin Infect Dis. 2004 Jan 1;38(1):53-61. doi: 10.1086/380452. Epub 2003 Dec 5.

Abstract

The clinical significance and virulence potential of Enterococcus casseliflavus/flavescens and Enterococcus gallinarum are still uncertain. We retrospectively analyzed 56 cases of significant bacteremia caused by E. casseliflavus or E. gallinarum. Of these cases, 25 (44.6%) were associated with polymicrobial bacteremia, and 43 (76.8%) were associated with entry via the biliary tract. Resistance to vancomycin was observed in 17 (30.4%) of these 56 patients, and this resistance was significantly associated with E. gallinarum bacteremia (adjusted odds ratio [AOR], 10.56; 95% confidence interval [CI], 2.41-46.27) and bacteremia without biliary tract origin (AOR, 6.74; 95% CI, 1.44-31.67). The crude mortality rate was 13%, and the bacteremia-related mortality rate was 1.9%. In conclusion, bacteremia due to E. casseliflavus and E. gallinarum is commonly associated with biliary tract disease and may be associated with a low risk of mortality.

摘要

格氏肠球菌/淡黄肠球菌和鹑鸡肠球菌的临床意义及潜在毒力仍不明确。我们回顾性分析了56例由格氏肠球菌或鹑鸡肠球菌引起的严重菌血症病例。在这些病例中,25例(44.6%)与多微生物菌血症相关,43例(76.8%)与经胆道途径感染有关。在这56例患者中,17例(30.4%)对万古霉素耐药,这种耐药与鹑鸡肠球菌菌血症(校正比值比[AOR],10.56;95%置信区间[CI],2.41 - 46.27)以及非胆道源性菌血症(AOR,6.74;95% CI,1.44 - 31.67)显著相关。粗死亡率为13%,菌血症相关死亡率为1.9%。总之,格氏肠球菌和鹑鸡肠球菌引起的菌血症通常与胆道疾病相关,且可能与低死亡风险有关。

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