A 5-Year Epidemiological Study of Monomicrobial Enterococcal Bloodstream Infection in a Population-Based Cohort.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-08-20 eCollection Date: 2025-09-01 DOI:10.1093/ofid/ofaf506

David R Bayless, Larry M Baddour, Brian D Lahr, Grace A Hagan, Jenny J Cao, Daniel C DeSimone

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Abstract

Background: The incidence, epidemiology, and clinical characteristics of enterococcal bloodstream infection (BSI) have not previously been studied on a population-based level in the United States.

Methods: We utilized the Expanded Rochester Epidemiology Project medical records linkage system to conduct a contemporary 5-year, retrospective, population-based study of monomicrobial enterococcal (ME) BSI among adult residents of 8 counties in southeast Minnesota from January 1, 2018 to December 31, 2022.

Results: A total of 109 cases of ME-BSI were identified. The overall age- and sex-adjusted incidence rate was 6.7 per 100 000 person-years (95% confidence interval, 5.4-7.9). Multivariable analysis revealed that male sex (P < .001) and older age (P < .001) were each independently associated with increased incidence, whereas no temporal association was demonstrated (year effect, P = .475). The median age of incident cases was 76.8 years (interquartile range, 65.0-83.3). Urinary tract source was the most common presumed source (42.2%), and Enterococcus faecalis was the predominant (83.5%) pathogen. Overall, 14.4% of patients met modified Duke criteria for definite infective endocarditis. Cumulative mortality was 28.4% at 12 weeks and 43.1% at 1 year.

Conclusions: In this population-based study, ME-BSI was significantly associated with older age and male sex. There was a high rate of mortality at 12 weeks and 1 year, with ∼1 out of 7 cases complicated by definite infective endocarditis. These findings underscore the importance of ongoing investigation of this syndrome.

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以人群为基础的队列中单菌肠球菌血液感染的5年流行病学研究

背景：在美国，肠球菌血流感染（BSI）的发病率、流行病学和临床特征尚未在基于人群的水平上进行过研究。方法：我们利用扩展罗切斯特流行病学项目医疗记录链接系统，在2018年1月1日至2022年12月31日期间，对明尼苏达州东南部8个县的成年居民进行了一项为期5年、回顾性、基于人群的单菌肠球菌（ME） BSI研究。结果：共发现ME-BSI 109例。经年龄和性别调整后的总发病率为6.7 / 10万人年（95%可信区间，5.4-7.9）。多变量分析显示，男性（P < .001）和年龄（P < .001）分别与发病率增加独立相关，而没有时间相关性（年效应，P = .475）。病例的中位年龄为76.8岁（四分位数范围为65.0-83.3岁）。尿路感染是最常见的感染源（42.2%），粪肠球菌是主要的感染源（83.5%）。总体而言，14.4%的患者符合确定感染性心内膜炎的修正Duke标准。12周和1年的累积死亡率分别为28.4%和43.1%。结论：在这项基于人群的研究中，ME-BSI与年龄和男性显著相关。12周和1年的死亡率很高，7例中有1例合并明确的感染性心内膜炎。这些发现强调了对该综合征进行持续调查的重要性。

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.