Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Enterococci are the third most common cause of healthcare-associated infections in the United States, affecting 10-12% of all transplant recipients worldwide. Enterococcal bacteremia complicates the post-transplant recovery and raises mortality to 18%. This study aims to identify factors linked to mortality in hematopoietic stem cell transplant (HSCT) recipients with Enterococcus infection. Methods: We conducted a retrospective analysis using the National Inpatient Sample Database (2018-2021). Adults treated with HSCT and admitted for Enterococcus infection were identified using ICD-10 codes. The analysis utilized descriptive statistics and multivariate regression, with significance at a p-value ≤0.05. Results: A total of 40,462 HSCT patients, 1.3% were admitted with Enterococcus infection. The crude mortality rate was higher in the Enterococcus cohort than in the non-Enterococcus cohort (10.4% vs. 4.6%); however, the mortality risk was substantially lower in the Enterococcus cohort (p<0.001). In the Enterococcus cohort, patients with fungal infections, sepsis, acute respiratory failure, and those with invasive ventilation had a high mortality risk (p<0.05). In leukemia patients treated with HSCT, the Enterococcus cohort had higher mortality than the non-Enterococcus cohort (12.5% vs. 5.0%; aOR 1.8, 95% CI 1.9-2.6, p=0.005). Conclusions: In HSCT recipients, Enterococcus infection is a clinical marker for poor prognosis. Early broad-spectrum antibiotic therapy is essential for patients with sepsis, respiratory compromise, and fungal co-infections. Additionally, a multidisciplinary team is crucial for managing respiratory and renal failure.
Source: Infezioni in Medicina
Authors: Barath Prashanth Sivasubramanian, Ajay Sriram Antony Raj, Diviya Bharathi Ravikumar, Aneela Satya Ravanam, Rutvi Balkrishna Patel, Samhitha Mudumalagurthy, Devi Meghana Kotharu, Mohd Zeeshan, Manisha Chavan, Jay Patel, Akhila Vala, Raghavendra Tirupathi, Rutul Dalal, Saketh Palasamudram Shekar
Institutions: Northeast Georgia Medical Center, Madras Medical College, Government of Andhra Pradesh, Narendra Modi Medical College, Kurnool Medical College, MNR Medical College and Hospital, Career Institute Of Medical & Dental Sciences and Hospital, Kakatiya University, Kakatiya Medical College, B.J. Medical College, Crozer-Keystone Health System, Pennsylvania State University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4408296687