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Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020

BACKGROUND: Hospital-acquired infections (HAI) caused by Enterococcus spp., especially vancomycin-resistant Enterococcus spp. (VRE), are of rising concern. AIM: We summarised data on incidence, mortality and proportion of HAI caused by enterococci in the World Health Organization European Region. ME...

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Autores principales: Brinkwirth, Simon, Ayobami, Olaniyi, Eckmanns, Tim, Markwart, Robby
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646982/
https://www.ncbi.nlm.nih.gov/pubmed/34763754
http://dx.doi.org/10.2807/1560-7917.ES.2021.26.45.2001628
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author Brinkwirth, Simon
Ayobami, Olaniyi
Eckmanns, Tim
Markwart, Robby
author_facet Brinkwirth, Simon
Ayobami, Olaniyi
Eckmanns, Tim
Markwart, Robby
author_sort Brinkwirth, Simon
collection PubMed
description BACKGROUND: Hospital-acquired infections (HAI) caused by Enterococcus spp., especially vancomycin-resistant Enterococcus spp. (VRE), are of rising concern. AIM: We summarised data on incidence, mortality and proportion of HAI caused by enterococci in the World Health Organization European Region. METHODS: We searched Medline and Embase for articles published between 1 January 2010 and 4 February 2020. Random-effects meta-analyses were performed to obtain pooled estimates. RESULTS: We included 75 studies. Enterococcus spp. and VRE accounted for 10.9% (95% confidence interval (CI): 8.7–13.4; range: 6.1–17.5) and 1.1% (95% CI: 0.21–2.7; range: 0.39–2.0) of all pathogens isolated from patients with HAI. Hospital wide, the pooled incidence of HAI caused by Enterococcus spp. ranged between 0.7 and 24.8 cases per 1,000 patients (pooled estimate: 6.9; 95% CI: 0.76–19.0). In intensive care units (ICU), pooled incidence of HAI caused by Enterococcus spp. and VRE was 9.6 (95% CI: 6.3–13.5; range: 0.39–36.0) and 2.6 (95% CI: 0.53–5.8; range: 0–9.7). Hospital wide, the pooled vancomycin resistance proportion among Enterococcus spp. HAI isolates was 7.3% (95% CI: 1.5–16.3; range: 2.6–11.5). In ICU, this proportion was 11.5% (95% CI: 4.7–20.1; range: 0–40.0). Among patients with hospital-acquired bloodstream infections with Enterococcus spp., pooled all-cause mortality was 21.9% (95% CI: 15.7–28.9; range: 14.3–32.3); whereas all-cause mortality attributable to VRE was 33.5% (95% CI: 13.0–57.3; range: 14.3–41.3). CONCLUSIONS: Infections caused by Enterococcus spp. are frequently identified among hospital patients and associated with high mortality.
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spelling pubmed-86469822021-12-23 Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020 Brinkwirth, Simon Ayobami, Olaniyi Eckmanns, Tim Markwart, Robby Euro Surveill Systematic Review BACKGROUND: Hospital-acquired infections (HAI) caused by Enterococcus spp., especially vancomycin-resistant Enterococcus spp. (VRE), are of rising concern. AIM: We summarised data on incidence, mortality and proportion of HAI caused by enterococci in the World Health Organization European Region. METHODS: We searched Medline and Embase for articles published between 1 January 2010 and 4 February 2020. Random-effects meta-analyses were performed to obtain pooled estimates. RESULTS: We included 75 studies. Enterococcus spp. and VRE accounted for 10.9% (95% confidence interval (CI): 8.7–13.4; range: 6.1–17.5) and 1.1% (95% CI: 0.21–2.7; range: 0.39–2.0) of all pathogens isolated from patients with HAI. Hospital wide, the pooled incidence of HAI caused by Enterococcus spp. ranged between 0.7 and 24.8 cases per 1,000 patients (pooled estimate: 6.9; 95% CI: 0.76–19.0). In intensive care units (ICU), pooled incidence of HAI caused by Enterococcus spp. and VRE was 9.6 (95% CI: 6.3–13.5; range: 0.39–36.0) and 2.6 (95% CI: 0.53–5.8; range: 0–9.7). Hospital wide, the pooled vancomycin resistance proportion among Enterococcus spp. HAI isolates was 7.3% (95% CI: 1.5–16.3; range: 2.6–11.5). In ICU, this proportion was 11.5% (95% CI: 4.7–20.1; range: 0–40.0). Among patients with hospital-acquired bloodstream infections with Enterococcus spp., pooled all-cause mortality was 21.9% (95% CI: 15.7–28.9; range: 14.3–32.3); whereas all-cause mortality attributable to VRE was 33.5% (95% CI: 13.0–57.3; range: 14.3–41.3). CONCLUSIONS: Infections caused by Enterococcus spp. are frequently identified among hospital patients and associated with high mortality. European Centre for Disease Prevention and Control (ECDC) 2021-11-11 /pmc/articles/PMC8646982/ /pubmed/34763754 http://dx.doi.org/10.2807/1560-7917.ES.2021.26.45.2001628 Text en This article is copyright of the authors or their affiliated institutions, 2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Systematic Review
Brinkwirth, Simon
Ayobami, Olaniyi
Eckmanns, Tim
Markwart, Robby
Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title_full Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title_fullStr Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title_full_unstemmed Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title_short Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
title_sort hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, who european region, 1 january 2010 to 4 february 2020
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646982/
https://www.ncbi.nlm.nih.gov/pubmed/34763754
http://dx.doi.org/10.2807/1560-7917.ES.2021.26.45.2001628
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