Enterococci urinary tract infection

Enterococci increasingly common cause of UTI.

Accounts for more than 30% of urinary tract infections among hospitalized patients.

Enterococci frequently resistant to many antibiotics and can develop resistance rapidly, suggesting overuse of antibiotics for enterococci oh bacteriuria should be avoided.

Enterococci in the urinary tract is often and asymptomatic process.

Asymptomatic bacteriuria should not be treated with antibiotics, except in patients undergoing neurologic manipulation and in pregnant women.

Increasing frequency of EUTIs in association with indwelling urinary catheters results frequently in the overtreatment of asymptomatic bacteriuria caused by enterococci.

The use of antibiotic therapy is a risk factor for the development of vancomycin resistant enterococcus and colonization with VRE is associated with increased rates of morbidity and mortality.

In a retrospective review of hospitalized patients with enterococcus positive urine cultures, 54% had asymptomatic bacteriuria and 46% had UTIs, and 70% of UTIs had associated pyuria, while only 42.3% of asymptomatic bacteriuria patients did (Lin E et al).

In the above study, it was felt that physicians inappropriately treated 32.8% of patients with antibiotics, and only pyuria was associated with inappropriate use of antibiotics.

In the above study only seven subsequent infections with enterococcus occurred in the 339 episodes of bacteriuria overall (2.1%), with two of 183 cases of asymptomatic bacteriuria, (1.1%), having distant infection.

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