Algorithm for empirical glycopeptide treatment in patients with hematologic malignancies and enterococcus faecium blood stream infection

Results Significant associations of E.faecium BSI were found with age, hospital stay prior to blood culture, duration of hospitalization 1 year before admission, fever prior to blood culture, severity and duration of neutropenia, CRP (C-reactive protein) at time of blood culture withdrawal, colonization with E. faecium prior to blood culture and diarrhea. E. faecium BSIs were found associated with more severe disease and higher mortality rates. Independent risk factors for E. faecium BSI were colonization with E. faecium 30 days prior to blood culture (OR 3.83; CI 1.1-12.8), fever > 1 day (4.02; 1.312.8), hospital stay prior to blood culture > 14 days (4.78; 1.3 -18.0), age > 59 years (5.47; 1.6-18.2) and abdominal pain, diarrhea or neutropenia (5.95; 1.1-31.4). Conclusion Using prognostic modeling, risk stratification is possible for development of E. faecium BSI in patients with hematological malignancies. Empirical treatment should be considered in patients who are at high risk.