Infectious Diseases Consultation Improves Treatment and Decreases Mortality by Enterococcal Bacteremia in Children

Munehiro Furuichi, Mihoko Furuichi, Yuho Horikoshi, Isao Miyairi

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Enterococci can cause severe infectious diseases (IDs). Delaying appropriate antibiotic therapy for enterococcal bacteremia is associated with increased patient mortality. Methods: We conducted a retrospective analysis examining the characteristics of children with enterococcal bacteremia at the 2 largest children’s hospitals in Japan. We compared outcomes of enterococcal bacteremia patients who received IDs consultation with those who did not. We also evaluated the risk factors for 30-day mortality after onset of enterococcal bacteremia. Results: One hundred fifty-two episodes of enterococcal bacteremia developed in 142 children. The most common pathogen was Enterococcus faecalis (94 episodes, 62%) followed by E. faecium (46 episodes, 30%). An underlying disease was present in 146 (96%) episodes. The most common type of infection was catheter-related blood stream infection (90, 59%). ID consultation, provided in 100 of 152 episodes of enterococcal bacteremia, was significantly associated with a higher rate of appropriate empiric therapy (84% versus 56%; P < 0.001) and appropriate definitive therapy (98% versus 73%; P < 0.001), treatment duration ≥7 days (97% versus 78%; P < 0.001), and the survival rate during 1 year postonset (P = 0.047). Seventeen children died within 30 days of enterococcal bacteremia onset. In multivariate analysis, those who received definitive therapy with penicillin without glycopeptides were at a statistically lower risk for death within 30 days after onset of enterococcal bacteremia (OR: 0.12; 95% confidence interval: 0.02–0.70; P = 0.02). Conclusions: ID consultation was associated with a higher rate of appropriate therapy and may decrease mortality because of enterococcal bacteremia in children.

Original languageEnglish
Pages (from-to)856-860
Number of pages5
JournalPediatric Infectious Disease Journal
Volume37
Issue number9
DOIs
Publication statusPublished - 2018 Sep 1
Externally publishedYes

Keywords

  • Appropriate treatment
  • Bacteremia
  • Enterococcus
  • Infectious diseases consultation
  • Mortality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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