An evaluation of the burden of invasive Enterococcal infection in a large university hospital

Objective: Enterococci represent an important cause of health-care associated infections. The purpose of this paper was to investigate the burden of invasive vancomycin resistance in Enterococcus spp in a large University Hospital of the South Italy in order to assess the local situation and, eventually, to develop preventive action strategies. — Materials and Methods: We performed a cross sectional study using the informative annual reports of the Microbiology Laboratory of the Messina University Hospital “G. Martino”, focusing on the invasive enterococci isolated in positive blood cultures in the three-year period 2015-2017. — Results: In the considered period, the number and percentages of blood cultures positive for enterococci were 28 (5.4%), 25 (3.6%) and 56 (7.9%) in the three years, respectively. Of these isolates, Enterococcus faecalis accounted for 76.8% while Enterococcus faecium for 23.1%. The majority of the invasive infections occurred in medical area (55.9%), followed by surgical (26.6%) and emergency ones (17.5%). The most interested wards were Nephrology, Metabolic Diseases and Internal Medicine for medical area and Vascular Surgery for surgical area. Only the 3.9% of invasive E. faecalis and the 3.7% of E. faecium were vancomycin resistant. — Conclusions: In our context, enterococci represent a minor cause of invasive infections. E. faecalis are, far away, the most isolated enterococcal species in general and in positive blood cultures, followed by distance by E. faecium. Moreover, the vancomycin-resistance is poorly represented in our setting. The data show that the patients more interested by invasive enterococcal infections and towards which it is necessary focus the preventive actions, were those suffering from metabolic disorders and kidney diseases, for medical wards, and patients suffering from vascular pathologies, for surgical wards.