Department of Infectious Diseases, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Department of Infectious Diseases, Daegu Catholic University Medical Center, Daegu, Republic of Korea.
Eur J Clin Microbiol Infect Dis. 2019 Sep;38(9):1743-1751. doi: 10.1007/s10096-019-03605-z. Epub 2019 Jun 26.
While the clinical characteristics and treatment outcomes of Enterococcus faecalis and E. faecium bacteremia are well known, those of E. durans bacteremia are still largely unclear. We retrospectively identified 80 adult E. durans bacteremia cases treated at our 2700-bed tertiary care hospital between January 1997 and December 2016. We compared the clinical characteristics and treatment outcomes of the adult patients with E. durans bacteremia (case group) with those of E. faecalis and E. faecium bacteremia cases (two control groups). The case and control groups were matched for sex, age, and date of onset of bacteremia. E. durans was responsible for 1.2% of all enterococcal bacteremia cases at our hospital. Of 80 cases, 39 (48.8%) had biliary tract infection and 18 (22.5%) had urinary tract infection. Community-onset bacteremia was more frequent in the case group than in the control groups (56.2% vs. 35.0% vs. 21.2%, p < 0.01). Infective endocarditis tended to be more common in the E. durans group (7.5% vs. 1.2% vs. 1.2%, p = 0.05). The majority of E. durans isolates were susceptible to penicillin (66/76, 86.8%), ampicillin (67/76, 88.2%), and vancomycin (75/76, 98.7%). The case group had significantly lower all-cause mortality (20.0% vs. 31.2% vs. 42.5%, p < 0.01) and bacteremia-related mortality (2.5% vs. 16.2% vs. 18.8%, p < 0.01) than the control groups. E. durans bacteremia mainly originates from the biliary or urinary tract and is associated with a lower risk of mortality.
虽然粪肠球菌和屎肠球菌菌血症的临床特征和治疗结果已经很清楚，但 durans 肠球菌菌血症的情况仍在很大程度上不清楚。我们回顾性地确定了 1997 年 1 月至 2016 年 12 月期间在我们 2700 张床位的三级保健医院接受治疗的 80 例成人 durans 肠球菌菌血症病例。我们比较了成人 durans 肠球菌菌血症（病例组）患者的临床特征和治疗结果与粪肠球菌和屎肠球菌菌血症病例（两组对照）的临床特征和治疗结果。病例组和对照组在性别、年龄和菌血症发病日期方面进行了匹配。在我们医院，durans 肠球菌占所有肠球菌菌血症病例的 1.2%。80 例中，39 例（48.8%）有胆道感染，18 例（22.5%）有尿路感染。社区获得性菌血症在病例组中比对照组更常见（56.2%比 35.0%比 21.2%，p < 0.01）。感染性心内膜炎在 durans 肠球菌组中更常见（7.5%比 1.2%比 1.2%，p = 0.05）。大多数 durans 肠球菌分离株对青霉素（66/76，86.8%）、氨苄西林（67/76，88.2%）和万古霉素（75/76，98.7%）敏感。病例组的全因死亡率（20.0%比 31.2%比 42.5%，p < 0.01）和菌血症相关死亡率（2.5%比 16.2%比 18.8%，p < 0.01）明显低于对照组。durans 肠球菌菌血症主要源自胆道或泌尿道，死亡率较低。
