Sörstedt Erik, Ahlbeck Gustaf, Snygg-Martin Ulrika
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, 416 50 Gothenburg, Sweden.
Microorganisms. 2024 Sep 24;12(10):1932. doi: 10.3390/microorganisms12101932.
Enterococcal bacteremia (EB) is on the rise both in Sweden and globally. While () is susceptible to ampicillin and piperacillin/tazobactam (pip/taz), () is not. Historically, most enterococcal infections have been caused by E. faecalis, but the epidemiology is changing with increasing recognition of enterococci as nosocomial pathogens and the emergence of resistance to commonly used antimicrobial agents. The use of pip/taz has increased dramatically in Sweden, but it is unknown if this has affected the relative incidence of bacteremia. Here, we investigate whether the number and proportion of bacteremia (EfmB) cases have increased. Additionally, risk factors associated with EfmB with a focus on prior antibiotic exposure are analyzed. Medical journals of 360 patients with EB admitted to Sahlgrenska University Hospital are reviewed. The proportion of EfmB cases increased from 41% in 2015 to 51% in 2021. Hospital-acquired infection, previous exposure to pip/taz, and carbapenems are identified as independent risk factors for EfmB. There are considerable patient-related differences between the EfmB and EfsB groups, but there is no difference in mortality rates. In conclusion, the increasing proportion of EfmB cases is concerning and is seen parallel to the expanding use of pip/taz, one possible contributing factor. Our findings suggest that a cautious approach to antibiotic use is essential to prevent the spread of antibiotic-resistant bacteria.
肠球菌血症（EB）在瑞典乃至全球都呈上升趋势。虽然（）对氨苄西林和哌拉西林/他唑巴坦（pip/taz）敏感，但（）却不敏感。从历史上看，大多数肠球菌感染是由粪肠球菌引起的，但随着肠球菌作为医院病原体的认知度不断提高以及对常用抗菌药物耐药性的出现，其流行病学正在发生变化。在瑞典，pip/taz的使用量急剧增加，但尚不清楚这是否影响了（）菌血症的相对发病率。在此，我们调查（）菌血症（EfmB）病例的数量和比例是否增加。此外，分析了与EfmB相关的风险因素，重点是既往抗生素暴露情况。对入住萨尔格伦斯卡大学医院的360例EB患者的医学记录进行了回顾。EfmB病例的比例从2015年的41%上升至2021年的51%。医院获得性感染、既往接触pip/taz和碳青霉烯类药物被确定为EfmB的独立风险因素。EfmB组和EfsB组之间存在相当大的患者相关差异，但死亡率没有差异。总之，EfmB病例比例的增加令人担忧，且与pip/taz使用的增加同时出现，pip/taz可能是一个促成因素。我们的研究结果表明，谨慎使用抗生素对于预防耐药菌的传播至关重要。
