Risk Factors for 30-Day Mortality in Nosocomial Enterococcal Bloodstream Infections

Enterococci commonly cause nosocomial bloodstream infections (BSIs), and the global incidence of vancomycin-resistant enterococci (VRE) BSIs is rising. This study aimed to assess the risk factors for enterococcal BSIs and 30-day mortality, stratified by species, vancomycin resistance, and treatment appropriateness. We conducted a retrospective cohort study (2014-2021) including all hospitalized adult patients with at least one blood culture positive for or . We included 584 patients with enterococcal BSI: 93 were attributed to vancomycin-resistant . The overall 30-day mortality was 27.5%; higher in cases of BSI due to vancomycin-resistant (36.6%) and vancomycin-sensitive (31.8%) compared to BSIs (23.2%) ( = 0.016). This result was confirmed by multivariable Cox analysis. Independent predictors of increased mortality included the PITT score, complicated bacteremia, and age (HR = 1.269, < 0.001; HR = 1.818, < 0.001; HR = 1.022, = 0.005, respectively). Conversely, male gender, consultation with infectious disease (ID) specialists, and appropriate treatment were associated with reduced mortality (HR = 0.666, = 0.014; HR = 0.504, < 0.001; HR = 0.682, = 0.026, respectively). In conclusion, vancomycin-resistant bacteremia is independently associated with a higher risk of 30-day mortality.