• Hervé Dupont, Arnaud Friggeri, Jérémy Touzeau, Norair Airapetian, François Tinturier, Eric Lobjoie, Emmanuel Lorne, Moustafa Hijazi, Jean-Marc Régimbeau, and Yazine Mahjoub.
• Department of Anesthesiology and Critical Care Medicine, Centre Hospitalier Universitaire d'Amiens, Place Victor Pauchet, 80054 Amiens cedex, France. dupont.herve@chu-amiens.fr
• J. Antimicrob. Chemother. 2011 Oct 1; 66 (10): 2379-85.

ObjectivesEnterococci may increase morbidity and mortality in elderly patients with intra-abdominal infections (IAIs) hospitalized in the intensive care unit (ICU).Patients And MethodsA single-centre, retrospective evaluation of an ICU database (1997-2007) of elderly ICU patients (≥75 years) with a severe IAI was performed. Demographics, severity scores, underlying diseases, microbiology and outcomes were recorded. Patients with enterococci isolated in peritoneal fluid (E+ group) were compared with those lacking enterococci in peritoneal fluid (E- group). Stepwise multivariate logistic regression was used to identify independent factors associated with mortality.ResultsOne hundred and sixty patients were included (mean ± SD age 82 ± 5 years; n = 72 in the E+ group). The E+ group was more severely ill than the E- group, with higher Simplified Acute Physiologic Score 2 (61 ± 20 versus 48 ± 16, P = 0.0001) and Sequential Organ Failure Assessment scores (8 ± 3 versus 5 ± 3, P = 0.0001), a greater postoperative infection rate (58.3% versus 34.1%, P = 0.01), a higher incidence of inappropriate empirical antimicrobial therapies (33.3% versus 19.3%, P = 0.04), a longer duration of mechanical ventilation (11.8 ± 10.9 versus 7.8 ± 10.2 days, P = 0.02) and greater vasopressor use (7.2 ± 7.1 versus 3.3 ± 4.1 days, P = 0.001). ICU mortality was higher in the E+ group than in the E- group (54.2% versus 38.6%, P = 0.05). In the multivariate analysis, E+ status was independently associated with mortality (odds ratio 2.24; 95% confidence interval 1.06-4.75; P = 0.03).ConclusionsIn severely ill, elderly patients in the ICU for an IAI, the isolation of enterococci was associated with increased disease severity and morbidity and was an independent risk factor for mortality.

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