{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:34:03Z","timestamp":1793226843719,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Background<\/jats:title>\n \n Enterococci are critical pathogens of hospital-acquired bloodstream infection (BSI), with\n E. faecalis<\/jats:italic>\n and\n E. faecium<\/jats:italic>\n as the predominant species. Their incidence has been increasing. This study compared clinical characteristics, predisposing factors, and in-hospital mortality between the two species to inform clinical management.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This single-center retrospective study enrolled adult patients with enterococcal BSI. Demographics, comorbidities, prior exposures, pre-existing infections, and SOFA scores were collected. Multivariable logistic regression identified factors associated with\n E. faecium<\/jats:italic>\n BSI (variables with\n p<\/jats:italic>\n &lt; 0.10 in univariate analysis were entered). Risk factors for mortality were analyzed using multivariable logistic regression with BIC-based optimal subset selection in the overall cohort and each species subgroup. A clinically prespecified model was adopted for sensitivity analysis in the overall cohort.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 294 enrolled patients, 185 (62.9%) had\n E. faecium<\/jats:italic>\n and 109 (37.1%) had\n E. faecalis<\/jats:italic>\n . The overall in-hospital mortality was 49.7%. Age \u2265 65 years (aOR = 1.71, 95% CI: 1.04\u20132.83,\n p<\/jats:italic>\n = 0.035) and ICU admission (aOR = 1.75, 95% CI: 1.01\u20133.04,\n p<\/jats:italic>\n = 0.045) were independently associated with\n E. faecium<\/jats:italic>\n BSI. Although mortality was higher in the\n E. faecium<\/jats:italic>\n group (53.0% vs. 44.0%), the difference did not reach statistical significance (\n p<\/jats:italic>\n = 0.139). Age \u2265 65 years, pneumonia, and SOFA score were independent risk factors for mortality in the overall cohort and\n E. faecium<\/jats:italic>\n subgroup (all\n p<\/jats:italic>\n &lt; 0.05). Only SOFA score was significant in the\n E. faecalis<\/jats:italic>\n subgroup. Enterococcal species did not show a significant association with mortality after multivariable adjustment (aOR = 1.49, 95% CI: 0.46\u20134.79,\n p<\/jats:italic>\n = 0.501).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In adult enterococcal BSI, hospital-acquired cases predominated.\n E. faecium<\/jats:italic>\n was the dominant species, with higher ICU admission rates and a greater proportion of elderly patients than\n E. faecalis<\/jats:italic>\n , although no statistically significant difference in mortality was observed. In the overall cohort and both subgroups, mortality was independently associated with disease severity, while no significant association was found for species.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1870585","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:54:30Z","timestamp":1790744070000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics, predisposing factors and outcomes of Enterococcus faecium and Enterococcus faecalis bloodstream infection in adults: a single-center retrospective study of 294 cases"],"prefix":"10.3389","volume":"16","author":[{"given":"Hua-Zheng","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Chuan","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Ao","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3390\/diagnostics14111190","article-title":"Characterization and antimicrobial susceptibility patterns of Enterococcus species isolated from nosocomial infections in a Saudi tertiary care hospital over a ten-year period (2012-2021)","volume":"14","author":"Al Bshabshe","year":"2024","journal-title":"Diagnostics (Basel Switzerland)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1093\/jac\/dks469","article-title":"Twenty-five years of shared life with vancomycin-resistant enterococci: is it time to divorce","volume":"68","author":"Cattoir","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"B3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1038\/s41579-018-0107-z","article-title":"Biofilm-associated infection by enterococci","volume":"17","author":"Ch'ng","year":"2019","journal-title":"Nat. Rev. Microbiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jhin.2022.01.011","article-title":"Clinical characteristics and microbiology of nosocomial enterococcal bloodstream infections in a tertiary-level hospital: a retrospective study, 2007-2019","volume":"122","author":"Dai","year":"2022","journal-title":"J. Hosp. Infection"},{"key":"B5","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jhin.2023.09.008","article-title":"Epidemiology and outcomes of vancomycin-resistant enterococcus infections: a systematic review and meta-analysis","volume":"141","author":"Eichel","year":"2023","journal-title":"J. Hosp. Infection"},{"key":"B6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3390\/antibiotics10020105","article-title":"Does vancomycin resistance increase mortality? Clinical outcomes and predictive factors for mortality in patients with Enterococcus faecium infections","volume":"10","author":"Hemapanpairoa","year":"2021","journal-title":"Antibiotics (Basel Switzerland)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am. J. Infect. Control"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab185","article-title":"Replacement of Enterococcus faecalis by Enterococcus faecium as the predominant enterococcus in UK bacteraemias","volume":"3","author":"Horner","year":"2021","journal-title":"JAC-Antimicrob. Resist."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1007\/s15010-024-02249-2","article-title":"Epidemiological trends and susceptibility patterns of bloodstream infections caused by Enterococcus spp. in six German university hospitals: a prospectively evaluated multicentre cohort study from 2016 to 2020 of the R-Net study group","volume":"52","author":"Hornuss","year":"2024","journal-title":"Infection"},{"key":"B10","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ijid.2023.04.411","article-title":"Impact of vancomycin resistance in Enterococcus faecium bloodstream infection on mortality: a retrospective analysis of nationwide surveillance data","volume":"134","author":"Huh","year":"2023","journal-title":"Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. For. Infect. Dis."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01067-25","article-title":"Epidemiology, clinical characteristics, and outcome of enterococcal bloodstream infections in critically ill patients in China: a single-center retrospective 10-year analysis","volume":"13","author":"Jin","year":"2025","journal-title":"Microbiol. Spectr."},{"key":"B12","article-title":"Enterococcal infection\u2014treatment and antibiotic resistance","volume-title":"Enterococci: From Commensals to Leading Causes of Drug Resistant Infection","author":"Kristich","year":"2014"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1007\/s11739-022-02926-w","article-title":"Clinical and microbiological characteristics of bloodstream infections caused by Enterococcus spp. within internal medicine wards: a two-year single-centre experience","volume":"17","author":"Lupia","year":"2022","journal-title":"Internal Emergency Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1007\/s10096-024-04917-5","article-title":"Clinical characteristics, predisposing factors and outcomes for Enterococcus faecalis versus Enterococcus faecium bloodstream infections: a prospective multicentre cohort study","volume":"43","author":"Scharloo","year":"2024","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"11577","DOI":"10.3390\/ijms241411577","article-title":"An overview of the factors involved in biofilm production by the Enterococcus genus","volume":"24","author":"\u0218chiopu","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1932","DOI":"10.3390\/microorganisms12101932","article-title":"Trends in Enterococcus faecium bacteremia: exploring risk factors with emphasis on prior antibiotic exposure","volume":"12","author":"S\u00f6rstedt","year":"2024","journal-title":"Microorganisms"},{"key":"B17","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1186\/s12866-025-04510-6","article-title":"Molecular epidemiology, antimicrobial resistance, and virulence determinants of Enterococcus faecium bloodstream isolates: a 7-year study in Shandong, China","volume":"25","author":"Sun","year":"2025","journal-title":"BMC Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1111\/j.1469-0691.2010.03394.x","article-title":"Mortality in enterococcal bloodstream infections increases with inappropriate antimicrobial therapy","volume":"17","author":"Suppli","year":"2011","journal-title":"Clin. Microbiol. Infection Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"B19","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1080\/23744235.2022.2131901","article-title":"Increasing trend in enterococcal bacteraemia and vancomycin resistance in a tertiary care hospital in Croatia, 2017-2021","volume":"55","author":"Todori\u0107","year":"2023","journal-title":"Infect. Dis. (London England)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"601","DOI":"10.3390\/antibiotics13070601","article-title":"Risk factors for 30-day mortality in nosocomial enterococcal bloodstream infections","volume":"13","author":"Zerbato","year":"2024","journal-title":"Antibiotics (Basel Switzerland)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s11596-017-1725-9","article-title":"Bloodstream infections caused by Enterococcus spp: a 10-year retrospective analysis at a tertiary hospital in China","volume":"37","author":"Zheng","year":"2017","journal-title":"J. Huazhong Univ. Sci. Technology. Med. Sci. = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying Wen Ban = Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1870585\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:54:40Z","timestamp":1790744080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1870585\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":21,"alternative-id":["10.3389\/fcimb.2026.1870585"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1870585","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1870585"}}