Abstract:

Objective

To preliminarily analyze the risk factors of Enterococcus faecium infections and drug resistance of Enterococcus faecium， and to provide clinical basis for empirical coverage of Enterococcus faecium in patients with critical abdominal infections.

Methods

A retrospective analysis was performed on 112 patients with critical abdominal infections in the Department of Critical Care Medicine in three districts of Tongji Hospital， Tongji Medical College of Huazhong University of Science and Technology from January 2016 to August 2021.According to whether they were infected with Enterococcus faecium， patients were divided into an infection group （24 cases） and a non-infection group （88 cases）， and factors that may be associated with Enterococcus faecium infections were statistically analyzed.

Results

A total of 112 patients with intra-abdominal infections were studied， yielding 188 non-repetitive pathogenic strains through abdominal drainage and / or blood cultures， including 24 strains of Enterococcus faecium （12.8%）.No vancomycin-resistant Enterococcus faecium （VREfm） was isolated.Comparisons between the two groups showed no statistically significant differences in terms of sex， age， ICU length of stay， sequential organ failure assessment scores ≥13， acute physiology and chronic health evaluation II scores ≥25， comorbidities， and prognosis （all P ＞0.05）.Multivariate logistic regression analysis indicated that intestinal mechanical barrier disruption ［odds ratio = 3.314， 95% confidence interval （1.147， 9.573）， P = 0.027］ was an independent risk factor for Enterococcus faecium infections in critically ill patients with intraabdominal infections.

Conclusions

Unlike previous studies， the use of third-generation cephalosporins and carbapenems in the ICU is not associated with Enterococcus faecium infections and does not promote VREfm infections.Intestinal mechanical barrier damage is an independent risk factor for Enterococcus faecium infections in patients with critical intraabdominal infections.

Key words: Intra-abdominal infection, Enterococcus faecium, Septic shock