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Clinical characteristics and risk factors in mixed-enterococcal bloodstream infections

Cheng Zheng  Jiachang Cai  Haizhou Liu  Shufang Zhang  Li Zhong  Nanxia Xuan  Hongwei Zhou  Kai Zhang  Yesong Wang  Xijiang Zhang  Baoping Tian  Zhaocai Zhang  Wei Cui  Gensheng Zhang  
【摘要】:Objectives:Although the enterococcal bloodstream infections(EBSI) are often observed in clinic,the mixedEBSI were few reported.The aim of this study was to investigate the clinical characteristics and risk factors of mixedEBSI in comparison with monomicrobial EBSI(mono-EBSI).Methods:A single center retrospective observational study was performed between Jan 1,2013 and Dec 31,2018 in a tertiary hospital.All patients with EBSI were enrolled,and their data were collected by reviewing electronic medical records.Results:A total of 451 patients with EBSI were enrolled including 157 cases(34.8%) with mixed-EBSI.The most common co-pathogens were Gram-negative bacteria(57.1%),followed by Gram-positive bacteria(38.3%) and fungi(4.6%).In multivariable analysis,burn injury(adjusted odds ratio [OR],0.136;95% confidence interval [CI],0.050-0.373),and length of prior hospital stay(aOR,1.009;95% CI,1.001-1.017) were associated with mixed-EBSI.Patients with mixed-EBSI developed with more proportion of septic shock(19% vs.31.8%,p=0.002),prolonged length of ICU stay [9(0,25) vs.15(2.5,36),p0.001] and hospital stay [29(16,49) vs.33(18.5,63),p=0.031].The mortality was not significantly different between mixed-EBSI and mono-EBSI(p=0.219).Conclusions:A high rate of mixed-EBSI was among EBSI,and the Gram-negative bacteria were the predominant co-existed species.Burn injury and length of prior hospital stay were independent risk factors for mixed-EBSI.Although the mortality was not different,patients with mixed-EBSI had poor outcomes in comparison with mono-EBSI,which merits more attention by physicians in the future.

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