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Korean Academy of Medical Sciences, Journal of Korean Medical Science, 1(25), p. 3, 2010

DOI: 10.3346/jkms.2010.25.1.3

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Clinical Features, Risk Factors and Outcomes of Bacteremia due to Enterococci with High-Level Gentamicin Resistance: Comparison with Bacteremia due to Enterococci without High-Level Gentamicin Resistance

Journal article published in 2010 by Hee-Chang Jang, Shinwon Lee ORCID, Kyoung-Ho Song, Jae Hyun Jeon, Wan Beom Park ORCID, Sang-Won Park ORCID, Hong Bin Kim, Hong Bin Kim ORCID, Nam Joong Kim, Eui-Chong Kim, Myoung-Don Oh ORCID, Kang Won Choe
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

High-level gentamicin resistance (HLGR) in enterococci has increased since the 1980s, but the clinical significance of the resistance and its impact on outcome have not been established. One hundred and thirty-six patients with bacteremia caused by enterococci with HLGR (HLGR group) were compared with 79 patients with bacteremia caused by enterococci without HLGR (non-HLGR group). Hematologic malignancy, neutropenia, Enterococcus faecium infection, nosocomial infection and monomicrobial bacteremia were more common in the HLGR group than the non-HLGR group, and APACHE II scores were also higher (P<0.05, in each case). Neutropenia, monomicrobial infection, stay in intensive care at culture, and use of 3rd generation cephalosporin, were independent risk factors for acquisition of HLGR enterococcal bacteremia. Fourteen-day and 30-day mortalities were higher in the HLGR group than the non-HLGR group in univariate analysis (37% vs. 15%, P=0.001; 50% vs. 22%, P<0.001). However, HLGR was not an independent risk factor for mortality due to enterococcal bacteremia in multivariate analysis. Therefore, HLGR enterococcal bacteremia is associated with more severe comorbid conditions and higher mortality than non-HLGR enterococcal bacteremia but the HLGR itself does not contribute significantly to mortality.