Clinical Features and Genomic Epidemiology of Bloodstream Infections due to Enterococcal Species Other Than Enterococcus faecalis or E faecium in Patients With Cancer

Authors

Dierdre B Axell-House
Patrycja A Ashley
Stephanie L Egge
Truc T Tran
Claudia Pedroza
Meng Zhang
An Q Dinh
Shelby R Simar
Pranoti V Sahasrabhojane
William R Miller
Samuel A Shelburne
Blake M Hanson
Cesar A Arias

Publication Date

6-1-2024

Journal

Open Forum Infectious Diseases

Abstract

BACKGROUND: Non–Enterococcus faecium, non–E. faecalis (NFF) enterococci are a heterogeneous group of clinically pathogenic enterococci that include species with intrinsic low-level vancomycin resistance. Patients with cancer are at increased risk for bacteremia with NFF enterococci, but their clinical and molecular epidemiology have not been extensively described.

METHODS: We conducted a retrospective review of all patients (n = 70) with NFF bacteremia from 2016 to 2022 at a major cancer center. The main outcomes assessed were 30-day mortality, microbiological failure (positive blood cultures for ≥4 days), and recurrence of bacteremia (positive blood cultureclearance). Whole-genome sequencing was performed on all available NFF (n = 65).

RESULTS: Patients with hematological malignancies made up 56% of the cohort (77% had leukemia). The majority of solid malignancies (87%) were gastrointestinal in origin. The majority of infections (83%) originated from an intra-abdominal source. The most common NFF species were

CONCLUSIONS: NFF bacteremia is caused by a heterogeneous population of isolates and is associated with significant mortality. Hematological malignancy is an important risk factor for infection with NFF resistant to multiple antibiotics.

Keywords

bloodstream infection, cancer, E. gallinarum, enterococci, vanC

Comments

Supplementary Materials

PMID: 38835498