036 Changing Trends in Enterococcal Bacteraemia

Background: The incidence of enterococcal bacteraemia (EB) is increasing. We ought to appraise the incidence and clinical characteristics of EB in the current decade. Methods: From 2001 2008, all adults with EB were included. Data on demographics, co-morbidities, severity (Charlson and Pitt scores), and clinical characteristics were obtained. Two periods were compared: 2001 2004 (P1) and 2005 2008 (P2). Results: There were 100 EB out of 3060 (3.3%) total bacteraemias. Median age was 71.5 y (range, 21 97), 65% were males; 27% were seen in P1 and 73% in P2 (p = 0.0006, CI 0.036 0.01) that represented 2% and 4.2% of all bacteraemias, respectively. 54% were due to E. faecalis and 23% to E. faecium. EB had a community-onset (C-O) in 56% of cases, polymicrobial in 32%. Nosocomial EB was due to urinarytract-infection (UTI) (39.5%), unknown-origin (U-O) 16.3% and 11.6% catheter-related. In C-O cases, 37% were UTI, 32% were biliary tract infection and 16% U-O. Endocarditis was diagnosed in 4% cases, all of C-O. 8% presented shock. LOS was 18 days and mortality 24%, 5/24 (21%) patients died within <72 h. Charlson score was 2.13 vs 3.38 (p = 0.027), respectively. There were no significant differences between both periods in terms of origin of EB, severity, LOS or mortality. Conclusions: The incidence of EB has doubled in the last 4 years in our hospital. A higher presence of co-morbidities in admitted patients could probably explain this finding. Enterococcal endocarditis remains a C-O entity. EB is rarely associated with shock or severity and it presents with a high late mortality rate.