A comparison of monomicrobial versus polymicrobial Enterococcus faecalis bacteriuria in a French University Hospital

• Published in: European journal of clinical microbiology & infectious diseases Vol. 34; no. 8; pp. 1667 - 1673
• Main Authors: Fourcade, C., Canini, L., Lavigne, J.-P., Sotto, A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2015; Springer Nature B.V; Springer Verlag
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Bacteria; Bacteriuria - epidemiology; Bacteriuria - microbiology; Bacteriuria - pathology; Biomedical and Life Sciences; Biomedicine; Catheters; Coinfection - epidemiology; Coinfection - microbiology; Coinfection - pathology; Colonization; Enterococcus faecalis; Enterococcus faecalis - isolation & purification; Epidemiologic Studies; Female; France - epidemiology; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - pathology; Hospitals; Hospitals, University; Human health and pathology; Humans; Infectious diseases; Internal Medicine; Laboratories; Length of stay; Life Sciences; Male; Medical instruments; Medical Microbiology; Microbiology and Parasitology; Microorganisms; Middle Aged; Multivariate analysis; Ostomy; Patients; Retrospective Studies; Risk Factors; Urinary tract infections; Urine; Urogenital system; Young Adult; France; Chronic Bacterial Prostatitis; Urinary Tract Infection; Urinary Catheter; Bacteriuria; Charlson Score
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-015-2403-0

Enterococci are of considerable relevance in the hospital setting. Their most common location is the urinary tract, where they may be responsible for both colonization and infections. They are often associated with the presence of other microorganisms. The aim was to compare monomicrobial and polymicrobial Enterococcus faecalis bacteriuria. A retrospective study was performed on the demographic, clinical, and laboratory data of 299 patients who had presented with E. faecalis bacteriuria in 2012 at a University Hospital. The bacteriuria was polymicrobial in 46.1 % of cases and in 36.4 % of cases was responsible for a urinary tract infection. Infections appeared to be more prevalent in the polymicrobial than the monomicrobial group (42 % vs 32 %, p  = 0.06). Half of the patients who presented with urinary tract colonization received antibiotic treatment (54/ out of 10). A multivariate analysis adjusted for age (adjusted odds ratio [AOR] = 1.02 per year, p  = 0.006), gender (AOR = 2.2, p  = 0.007), and clinical classification (colonization or infection, AOR = 1.6, p  = 0.091), showed that diabetes mellitus (AOR = 2.0, p  = 0.04), hospital length of stay exceeding 28 days (AOR = 2.0, p  = 0.03), and presence of a urinary catheter (AOR = 2.4, p  = 0.001) were all factors associated with polymicrobial E. faecalis bacteriuria. A reduction in the length of hospital stay and the use of urinary catheters would appear to be required to decrease the incidence of urinary tract colonization and infections by polymicrobial E. faecalis . Improper use of antibiotics to treat urinary tract colonization remains a major concern.