Antibiotic Resistance, Risk Factors, and Clinical Outcome of Enterococcal Bloodstream Infection in Tertiary Care Hospitals in Coastal Karnataka, India.

BACKGROUND

Enterococcal bloodstream infections (BSIs) cause substantial morbidity and mortality, with rising multidrug resistance, particularly vancomycin-resistant enterococci (VRE), complicating management.

OBJECTIVES

To study antimicrobial resistance, risk factors, and clinical outcomes of enterococcal BSIs in tertiary care hospitals.

MATERIALS AND

METHODS

This prospective study (July 2021-June 2022) included 67 patients with enterococcal bacteremia. Demographic and clinical data, comorbidities, and outcomes were analysed. Antimicrobial susceptibility testing, vancomycin MIC determination, and molecular detection of VRE were performed.

RESULTS

Among the 67 patients, the mean age was 54.1 years, and 35 patients had comorbidities, predominantly diabetes mellitus and chronic kidney disease. Isolates included Enterococcus faecalis (37) and Enterococcus faecium (27). Vancomycin resistance was detected in 13 isolates, mainly E. faecium . Mortality was significantly higher in VRE infections than in VSE ( P = 0.037), with overall mortality of 43.2%.

CONCLUSIONS

E. faecium showed higher resistance and mortality. Injudicious use of meropenem and fluoroquinolones may promote VRE selection, underscoring the need for robust antimicrobial stewardship.