Clinical features and outcomes of bacteremia caused by Enterococcus casseliflavus and Enterococcus gallinarum: Analysis of 56 cases

The clinical significance and virulence potential of Enterococcus casseliflavus/ flavescens and Enterococcus gallinarum are still uncertain. We retrospectively analyzed 56 cases of significant bacteremia caused by E. casseliflavus or E. gallinarum. Of these cases, 25 ( 44.6%) were associated with polymicrobial bacteremia, and 43 ( 76.8%) were associated with entry via the biliary tract. Resistance to vancomycin was observed in 17 ( 30.4%) of these 56 patients, and this resistance was significantly associated with E. gallinarum bacteremia ( adjusted odds ratio [ AOR], 10.56; 95% confidence interval [ CI], 2.41 - 46.27) and bacteremia without biliary tract origin ( AOR, 6.74; 95% CI, 1.44 - 31.67). The crude mortality rate was 13%, and the bacteremia- related mortality rate was 1.9%. In conclusion, bacteremia due to E. casseliflavus and E. gallinarum is commonly associated with biliary tract disease and may be associated with a low risk of mortality.