Evaluation of bacteremia caused by gram-positive bacteria

In our study, the demographic, clinical, and laboratory characteristics, antimicrobial treatments, and mortality rates of patients who were hospitalized in clinical wards and intensive care units at Eskişehir Osmangazi University Hospital and had positive blood cultures for Staphylococcus aureus (S. aureus), Enterococcus faecium (E. faecium), and Enterococcus faecalis (E. faecalis) were evaluated. This retrospective study included 475 patients who were hospitalized between January 1, 2019, and May 26, 2023. Of these patients, 51.2% were monitored in intensive care units, while 48.8% were followed in clinical wards. The most frequently isolated microorganism was S. aureus, followed by E. faecium and E. faecalis. At least one comorbidity was present in 92% of the cases, with diabetes mellitus, peripheral arterial disease, and solid tumors being the most common. Carbapenems and glycopeptides were the most frequently preferred agents in empirical antibiotic therapy. Microbiological analyses of the isolated strains revealed notable antibiotic resistance, especially in E. faecium isolates. However, the rate of MRSA was found to be lower than those reported in many studies in the literature. In terms of mortality, the highest all-cause mortality rate on day 28 was observed in patients with E. faecium bacteremia (54.5%). This high rate was attributed to the patients' advanced age, multiple comorbidities, and greater need for intensive care. In conclusion, our study demonstrates that gram-positive bacteremias still occur to a certain extent and highlights the critical importance of empirical treatment and close monitoring, particularly in infections caused by resistant organisms.