P-56. Clinical and Microbiological Profile of Enterococcal Bacteremia in a Tertiary Hospital in the Dominican Republic

TL;DR

This study examines the clinical and microbiological features of enterococcal bacteremia in a Dominican hospital, highlighting common pathogens and resistance patterns.

Contribution

The study provides new local data on enterococcal bacteremia in the Dominican Republic, including resistance patterns and clinical outcomes.

Findings

E. faecalis was the most common isolate (92.9%), followed by E. faecium and E. gallinarum.

High resistance rates were observed for tetracycline, erythromycin, and gentamicin among E. faecalis isolates.

Vancomycin and ampicillin showed high efficacy, with 70.8% of patients achieving negative blood cultures within 7 days.

Abstract

Enterococcal bacteremia is an emerging concern in hospitalized patients, often associated with multidrug resistance and high morbidity. Limited data exists in the Dominican Republic on its clinical features and outcomes.

Antimicrobial resistance patterns by Enterococcus Species

Types of Enterococcus

A retrospective cross-sectional study was conducted at Hospital General Plaza de la Salud from January 2022 to December 2023. Medical records were reviewed to collect demographic, clinical, microbiological, and outcome data on patients with blood culture–confirmed Enterococcus spp. bacteremia.

Seventy-one patients were included, predominantly male (64.7%), with a median age distribution favoring patients over 60 years (64.7%). Comorbidities included chronic kidney disease (43.6%), diabetes (36.6%), and hypertension (18%). Most cases (70.4%) were nosocomial. E faecalis accounted for 92.9% of isolates, followed by E. faecium (5.6%) and E. gallinarum (1.4%). High resistance rates were noted for tetracycline (80.3%), erythromycin (59.1%), and gentamicin (54.5%) among E. faecalis isolates, while 50% of E. faecium isolates showed resistance to ampicillin, linezolid, and daptomycin (Figure 1). No vancomycin resistance was detected.

Vancomycin and ampicillin were the most commonly used treatments, with 70.8% achieving negative blood cultures within 7 days. Bacteremia recurrence occurred in 11.1% of cases. Complications included sepsis (28.1%), endocarditis (8.4%), and pneumonia (7.0%). The overall mortality rate was 28.8%, and 54.1% of patients had hospital stays exceeding 20 days.

Enterococcal bacteremia predominantly affects elderly, vulnerable patients with significant comorbidities in our cohort. E. faecalis remains the most common pathogen, and despite notable resistance patterns, vancomycin and ampicillin retain high efficacy. Early identification, appropriate antibiotic stewardship, and device management strategies are crucial to improve outcomes and prevent recurrences.

Rita A. Rojas-Fermín, MD, GSK: Honoraria

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