{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:06:47Z","timestamp":1792678007292,"version":"4.5.0"},"reference-count":25,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82402626"],"award-info":[{"award-number":["82402626"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Enterococcal bloodstream infections (BSIs) in critically ill patients are linked to multidrug resistance (MDR), high morbidity, and increased mortality. We conducted a retrospective cohort study over a decade at a 3,500-bed teaching hospital, including intensive care unit patients diagnosed with enterococcal BSIs. Data on demographics, comorbidities, severity scores, treatments, and microbiological profiles were analyzed. Risk factors for infection and mortality were assessed using multivariate logistic regression. Among 101 patients,\n                      <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                      was the predominant species, with nearly half of these isolates exhibiting MDR, particularly to ampicillin, aminoglycosides, and fluoroquinolones. Primary infection sources among all patients included abdominal (58.4%), catheter-related (32.7%), and wound infections (10.9%). Key mortality risk factors included a high Charlson comorbidity index (CCI \u2265 5; hazard ratio [HR] = 18.18,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), male sex (HR = 3.09,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0174), prolonged hospitalization, mechanical ventilation &gt;7 days, central venous catheter (CVC) use, prior broad-spectrum antibiotic exposure, immunosuppression, and delayed antimicrobial therapy (&gt;24 hours; HR = 11.11,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Prior fluoroquinolone exposure and inadequate source control also increased mortality risk. In contrast, early source control (HR = 0.08,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), timely targeted therapy (HR = 0.09,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.00214), and early CVC removal (HR = 0.01,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) improved survival. Persistent bacteremia and inflammatory markers were not independent mortality predictors. Future research should optimize antibiotic duration, refine risk prediction models, and develop novel therapies for MDR\n                      <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic>\n                      infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Enterococcal bloodstream infections are a serious concern in critically ill patients, often associated with multidrug resistance (MDR) and high mortality rates. This study highlights the importance of early intervention, including source control and timely antimicrobial therapy, in improving patient outcomes. By identifying key risk factors for mortality, such as comorbidities, male sex, and delayed treatment, this research provides valuable insights for clinicians in managing these infections. Notably, the study emphasizes the crucial role of early removal of central venous catheters and targeted therapy in reducing mortality risk. These findings underscore the need for effective infection prevention strategies and timely clinical decisions in critically ill patients. This work lays the foundation for future research aimed at optimizing treatment approaches and combating the growing challenge of MDR\n                      <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic>\n                      infections in intensive care settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01067-25","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T13:00:33Z","timestamp":1754917233000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["Epidemiology, clinical characteristics, and outcome of enterococcal bloodstream infections in critically ill patients in China: a single-center retrospective 10-year analysis"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1761-7728","authenticated-orcid":true,"given":"Ye","family":"Jin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/059cjpv64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of General Intensive Care Unit, the Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, People's Republic of China"]},{"id":[{"id":"https:\/\/ror.org\/00a2xv884","id-type":"ROR","asserted-by":"publisher"}],"name":"Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education","place":["Hangzhou, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Yi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/059cjpv64","id-type":"ROR","asserted-by":"publisher"}],"name":"Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and 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Enterococci: from commensals to leading causes of drug resistant infection. 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