TABLE 1.
Demographic, epidemiological, and baseline characteristics of bloodstream infections from a biliary tract source, and according to isolation of Enterococcus faecalis and Enterococcus faecium in blood cultures
| Variables | All patients n =850 (%) |
Isolation of E. faecalis or E. faecium (n = 73) | No isolation - others (n = 777) | P value |
|---|---|---|---|---|
| Demographic | ||||
| Median age in yrs (IQR) | 76 (65.84) | 75 (63-83) | 76 (66-84) | 0.11 |
| Female sex | 313 (36.8) | 29 (39.7) | 284/775 (36.6) | 0.60 |
| Acquisition | ||||
| Community acquired | 452 (53.2) | 22 (30.1) | 430 (55.4) | <0.001 |
| Community-onset, health-care related | 224 (26.4) | 16 (21.9) | 208 (26,8) | 0.36 |
| Hospital acquired | 173 (20.4) | 35 (47.9) | 138 (17.8) | <0.001 |
| Comorbidities | ||||
| Median age-adjusted Charlson comorbidity index (IQR) | 5 (3-7) | 6 (4-8) | 5 (3-7) | 0.038 |
| Congestive heart failure | 68 (8.0) | 4 (5.5) | 64 (8.2) | 0.50 |
| Hypertension | 65 (7.6) | 6 (8.2) | 59 (7.6) | 0.84 |
| Dementia | 61 (7.2) | 6 (8.2) | 55 (7.1) | 0.71 |
| Cerebrovascular disease | 58 (6.8) | 4 (5.5) | 54 (6.9) | 0.27 |
| Chronic obstructive pulmonary disease | 90 (10.6) | 8 (11) | 82 (10.6) | 0.91 |
| Diabetes mellitus | 212 (24.9) | 18 (24.7) | 194 (25) | 0.95 |
| Diabetes mellitus with organ damage | 43 (5.1) | 5 (6.8) | 38 (4.9) | 0.40 |
| Moderate/severe liver disease | 83 (9.8) | 14 (19.2) | 69 (8.9) | 0.005 |
| Chronic kidney disease (stage 4-5) | 75 (8.8) | 11 (15.1) | 64 (8.2) | 0.04 |
| Connective tissue disorder | 18 (2.1) | 2 (2.7) | 16 (2.1) | 0.66 |
| Peptic ulcer | 22 (2.6) | 1 (4.5) | 21 (2.7) | 1.00 |
| Peripheral vascular disease | 57 (6.7) | 7 (9.6) | 60 (6.4) | 0.30 |
| Cancer | 252 (29.6) | 33 (45.2) | 219 (28.2) | 0.005 |
| Cholangiocarcinoma | 15 (1.8) | 6 (8.2) | 9 (1.2) | <0.001 |
| Pancreatic cancer | 13 (1.5) | 3 (4.1) | 10 (1.3) | 0.093 |
| Hematologic cancer | 18 (2.1) | 2 (2.7) | 16 (2.1) | 0.69 |
| Urinary obstruction | 9 (1.1) | 0 | 9 (1.2) | 1.00 |
| Recurrent urinary tract infection | 15 (1.8) | 3 (4.1) | 12 (1.5) | 0.11 |
| Biliary tract obstruction | 268 (31.5) | 27 (37) | 241 (31) | 0.29 |
| Immunosuppressive therapy | 67 (7.9) | 12 (16.4) | 55 (7.1) | 0.005 |
| Neutropenia <500 cells/μL | 12 (1.4) | 0 (0) | 12 (1.5) | 0.28 |
| Medical device and procedures | ||||
| Biliary tract prosthesis | 153 (18) | 24 (32.9) | 129 (16.6) | 0.001 |
| Surgery (30 days before) | 48 (5.6) | 9 (12.3) | 39 (5) | 0.010 |
| Biliary surgery | 32 (3.8) | 7 (9.6) | 25 (3.2) | 0.006 |
| Parenteral feeding | 17 (2) | 5 (6.8) | 12 (1.5) | 0.002 |
| Esophagogastroduodenoscopy | 13 (1.5) | 2 (2.7) | 11 (1.4) | 0.30 |
| Endoscopic retrograde cholangiopancreatography | 5 (0.6) | 2 (2.7) | 3 (0.4) | 0.061 |
| Other upper gastrointestinal endoscopy | 50 (5.9) | 12 (16.4) | 38 (4.9) | <0.001 |
| Colonoscopy | 4 (0,5) | 0 | 4 (0.5) | 1.00 |
| Bronchoscopy | 34 (4) | 8 (11) | 26 (3.3) | 0.002 |
| Mechanical ventilation | 8 (0.9) | 4 (5.5) | 4 (0.5) | 0.003 |
| Previous antimicrobial treatment (30 days before) | ||||
| Any antimicrobial | 201 (23.6) | 30 (41.4) | 171 (22) | <0.001 |
| Beta-lactam/beta-lactam inhibitor | 115 (13.5) | 20 (27.4) | 95 (12.2) | <0.001 |
| Carbapenem | 32 (3.8) | 11 (15.1) | 21 (2.7) | <0.001 |
| Third generation cephalosporin | 10 (1.2) | 9 (1.2) | 1 (1.4) | 0.87 |
| Severity at presentation | ||||
| Sepsis and septic shock | 251 (29.5) | 28 (38.4) | 223 (28.7) | 0.084 |
| SOFA ≥ 2 | 344 (40.5) | 37 (50.7) | 307 (39.5) | 0.080 |
| Pitt score > 3 | 60 (7.1) | 8 (13.3) | 52 (6.7) | 0.17 |