Association between Enterococcus bacteraemia and death in neutropenic patients with haematological malignancies Giuseppe Todeschini a , Cristina Tecchio a , Carlo Borghero a , Anna D’Emilio b , Enrico Pegoraro c , Fausto de Lalla d , Paolo Benedetti d , Paolo Spolaore e , Giampietro Pellizzer d, * a Department of Haematology, University of Verona, Verona, Italy b Department of Haematology, San Bortolo Hospital, Vicenza, Italy c Unit of Statistics, San Bortolo Hospital, Vicenza, Italy d Department of Infectious Diseases and Tropical Medicine, San Bortolo Hospital, 36100 Vicenza, Italy e San Bortolo Hospital, Vicenza, Italy Accepted 14 November 2005 Available online 4 January 2006 KEYWORDS Enterococcus bacteraemia; Neutropenia; Haematological malignancies Summary Fatality rates and prognostic factors for mortality due to Enterococcus spp. bacteraemia have not yet been fully defined in the setting of neutropenic patients affected with haematological malignancies. We have performed a retro- spective, multi-centre cohort study on 98 episodes of Enterococcus bacteraemia oc- curring in patients hospitalised from January 1984 to December 2001 at the oncohaematology units in two tertiary-care hospitals (Verona Hospital and Vicenza Hospital, in north-east Italy). E. faecalis was isolated in 52 cases (53%), E. faecium in 39 (39.8%), E. avium in four, E. durans in one, and untyped Enterococcus spp. in two other cases; vancomycin resistance was detected in 15 (15.3%) isolates. A global mortality rate of 41.8% (41/98 cases) was revealed; Enterococcus spp. bacteraemia was associated with a fatal outcome in 29/98 cases (29.5%). The following variables were independently associated with an increased risk of death by multivariate anal- ysis of survival: age 50 years (OR 3.74; 95% CI 1.35e10.32), pneumonia (OR 4.70; 95% CI 1.67e13.20), and shock (OR 13.7; 95% CI 1.23e152.43), while the initial phase of haematological disease (responsive to chemotherapy) appeared to be protective (OR 0.23; 95% CI 0.008e0.64, P level 0.005); however, pneumonia alone (OR 7.2, 95% CI 2.52e20.88) was independently associated with fatal outcome by multivariate analysis for death related to enterococcal bacteraemia. In our * Corresponding author. Tel.: þ39 0444 993998; fax: þ39 0444 993616. E-mail address: gp.pellizzer@ulssvicenza.it (G. Pellizzer). 0163-4453/$30 ª 2005 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2005.11.012 Journal of Infection (2006) 53, 266e273 www.elsevierhealth.com/journals/jinf