COMPARATIVE-STUDY OF BACTEREMIAS CAUSED BY ENTEROCOCCUS SPP. WITH ANDWITHOUT HIGH-LEVEL RESISTANCE TO GENTAMICIN

A prospective, multicenter study was carried out over a period of 10 m onths. All patients with clinically significant bacteremia caused by E nterococcus spp, were included. The epidemiological, microbiological, clinical, and prognostic features and the relationship of these featur es to the presence of high-level resistance to gentamicin (HLRG) were studied, Ninety-three patients with enterococcal bacteremia were inclu ded, and 31 of these cases were caused by HLRG (33%), The multivariate analysis selected chronic renal failure, intensive care unit stay, pr evious use of antimicrobial agents, and Enterococcus faecalis species as the independent risk factors that influenced the development of HLR G. The strains with HLRG showed lower levels of susceptibility to peni cillin and ciprofloxacin. Clinical features (except for chronic renal failure) were similar in both groups of patients. HLRG did not influen ce the prognosis for patients with enterococcal bacteremia in terms of either the crude mortality rate (29% for patients with bacteremia cau sed by enterococci with HLRG and 28% for patients not infected with st rains with HLRG) or the hospital stay after the acquisition of enteroc occal bacteremia. Hemodynamic compromise, inappropriate antimicrobial therapy, and mechanical ventilation were revealed in the multivariate analysis to be the independent risk factors for mortality, Prolonged h ospitalization was associated with the nosocomial acquisition of bacte remia and polymicrobial infections.