Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure
Enterococcal bacteremia (EB) is on the rise both in Sweden and globally. While <i>Enterococcus faecalis</i> (<i>E. faecalis</i>) is susceptible to ampicillin and piperacillin/tazobactam (pip/taz), <i>Enterococcus faecium</i> (<i>E. faecium</i>) is not....
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MDPI AG
2024-09-01
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| author | Erik Sörstedt Gustaf Ahlbeck Ulrika Snygg-Martin |
| author_facet | Erik Sörstedt Gustaf Ahlbeck Ulrika Snygg-Martin |
| author_sort | Erik Sörstedt |
| collection | DOAJ |
| description | Enterococcal bacteremia (EB) is on the rise both in Sweden and globally. While <i>Enterococcus faecalis</i> (<i>E. faecalis</i>) is susceptible to ampicillin and piperacillin/tazobactam (pip/taz), <i>Enterococcus faecium</i> (<i>E. faecium</i>) 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 <i>E. faecalis/E. faecium</i> bacteremia. Here, we investigate whether the number and proportion of <i>E. faecium</i> 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. |
| format | Article |
| id | doaj-art-0bcceecf872342ac96b7fb5eb6bafd1a |
| institution | OA Journals |
| issn | 2076-2607 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-0bcceecf872342ac96b7fb5eb6bafd1a2025-08-20T02:10:57ZengMDPI AGMicroorganisms2076-26072024-09-011210193210.3390/microorganisms12101932Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic ExposureErik Sörstedt0Gustaf Ahlbeck1Ulrika Snygg-Martin2Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SwedenDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SwedenDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, SwedenEnterococcal bacteremia (EB) is on the rise both in Sweden and globally. While <i>Enterococcus faecalis</i> (<i>E. faecalis</i>) is susceptible to ampicillin and piperacillin/tazobactam (pip/taz), <i>Enterococcus faecium</i> (<i>E. faecium</i>) 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 <i>E. faecalis/E. faecium</i> bacteremia. Here, we investigate whether the number and proportion of <i>E. faecium</i> 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.https://www.mdpi.com/2076-2607/12/10/1932enterococcal bacteraemiaantibiotic resistance<i>Enterococcus faecium</i>piperacillin/tazobactam |
| spellingShingle | Erik Sörstedt Gustaf Ahlbeck Ulrika Snygg-Martin Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure Microorganisms enterococcal bacteraemia antibiotic resistance <i>Enterococcus faecium</i> piperacillin/tazobactam |
| title | Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure |
| title_full | Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure |
| title_fullStr | Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure |
| title_full_unstemmed | Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure |
| title_short | Trends in <i>Enterococcus faecium</i> Bacteremia: Exploring Risk Factors with Emphasis on Prior Antibiotic Exposure |
| title_sort | trends in i enterococcus faecium i bacteremia exploring risk factors with emphasis on prior antibiotic exposure |
| topic | enterococcal bacteraemia antibiotic resistance <i>Enterococcus faecium</i> piperacillin/tazobactam |
| url | https://www.mdpi.com/2076-2607/12/10/1932 |
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