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Abstract

Background

Hospital-acquired infections (HAI) caused by spp., especially vancomycin-resistant (VRE), are of rising concern.

Aim

We summarised data on incidence, mortality and proportion of HAI caused by enterococci in the World Health Organization European Region.

Methods

We searched Medline and Embase for articles published between 1 January 2010 and 4 February 2020. Random-effects meta-analyses were performed to obtain pooled estimates.

Results

We included 75 studies. spp. and VRE accounted for 10.9% (95% confidence interval (CI): 8.7–13.4; range: 6.1–17.5) and 1.1% (95% CI: 0.21–2.7; range: 0.39–2.0) of all pathogens isolated from patients with HAI. Hospital wide, the pooled incidence of HAI caused by spp. ranged between 0.7 and 24.8 cases per 1,000 patients (pooled estimate: 6.9; 95% CI: 0.76–19.0). In intensive care units (ICU), pooled incidence of HAI caused by spp. and VRE was 9.6 (95% CI: 6.3–13.5; range: 0.39–36.0) and 2.6 (95% CI: 0.53–5.8; range: 0–9.7). Hospital wide, the pooled vancomycin resistance proportion among spp. HAI isolates was 7.3% (95% CI: 1.5–16.3; range: 2.6–11.5). In ICU, this proportion was 11.5% (95% CI: 4.7–20.1; range: 0–40.0). Among patients with hospital-acquired bloodstream infections with spp., pooled all-cause mortality was 21.9% (95% CI: 15.7–28.9; range: 14.3–32.3); whereas all-cause mortality attributable to VRE was 33.5% (95% CI: 13.0–57.3; range: 14.3–41.3).

Conclusions

Infections caused by spp. are frequently identified among hospital patients and associated with high mortality.

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Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Simon+Brinkwirth&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brinkwirth Simon</a>, <a href="/search?value1=Olaniyi+Ayobami&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ayobami Olaniyi</a>, <a href="/search?value1=Tim+Eckmanns&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eckmanns Tim</a>, <a href="/search?value1=Robby+Markwart&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Markwart Robby</a></span>. Hospital-acquired infections caused by enterococci: a systematic review and meta-analysis, WHO European Region, 1 January 2010 to 4 February 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(45):pii=2001628. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.45.2001628" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.45.2001628</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 01 Sept 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 May 2021 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.45.2001628
/content/10.2807/1560-7917.ES.2021.26.45.2001628
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