Treatment duration of enterococcal intravascular catheter-related infections

Enterococcal bloodstream infection (BSI) is associated with high morbidity and mortality. Interestingly, enterococcal BSI central-line (CLABSI) or intravascular devices (catheter-related BSI, CRBSI) has shown an increasing incidence proportion [[1]Novosad S.A. Fike L. Dudeck M.A. Allen-Bridson K. Edwards J.R. Edens C. et al.Pathogens causing central-line-associated infections in acute-care hospitals—United States, 2011–2017.Infect Control Hosp Epidemiol. 2020; 41: 313-319https://doi.org/10.1017/ice.2019.303Crossref PubMed Scopus (13) Google Scholar,[2]Buetti N. Lo Priore E. Atkinson A. Widmer A.F. Kronenberg Marschall J. Catheter-related infections: does the spectrum of microbial causes change over time? A nationwide surveillance study.BMJ Open. 2018; 8e023824https://doi.org/10.1136/bmjopen-2018-023824Crossref (10) Scholar]. We read great interest review Rosselli Del Turco al. which authors recommended 2-4 weeks treatment (Table 1) for related to endovascular (central venous catheters (CVCs) including haemodialysis catheters, peripherally inserted central (PICCs), midline catheters) [[3]Rosselli Bartoletti M. Dahl Cervera Pericàs J.M. How do I manage a patient bacteraemia?.Clin Microbiol Infect. 26: 1395-1399PubMed Scholar].Table 1Summary recommendations expert opinionsFirst authorJournalYearSettingRecommended duration CRBSI/CLABSIWhen prolonged therapy?German guidelinesBöll BAnn Hematol2020Oncology5–7 days after defervescenceComplications (endocarditis, osteomyelitis)French recommendationsTimsit JFAnn Intensive Care2020ICU7 daysRemote complicationsExpert statementBuetti NSemin Respir Crit Care Med2019ICU(5–)7 daysPersistent CRBSI, complicated courses (i.e. another vascular line infection, metastatic abscess, septic thrombophlebitis, endocarditis)Spanish recommendationsChaves FMed Intensiva2018ICU7–14 daysNot specifiedInternational consensus statementTimsit JFIntensive Med2018ICU7–14 bacteraemia, complications bacteraemia suppurative endocarditis, osteomyelitis, infection)Expert statementRupp MInfect Dis Clin North Am2018All catheters7–14 daysComplicated CRBSI persistent infective endocarditis)IDSA guidelines (US)Mermel LClin. Dis.2009All catheters7-14 endocarditis)ICU, intensive care unit; catheter-related infection; CLABSI, IDSA, Infectious Diseases Society America; US, United states. Open table new tab ICU, To our knowledge, no high-quality study specifically addressed question antimicrobial therapy intravascular-catheter-related infections. performed systematic search MEDLINE on 10th November 2020 (search terms algorithm: “(Catheter-Related Infections[MeSH] AND (intravascular OR blood) CLABSI infection) (central-line Enterococcus[MeSH] (AntiBacterial Agents[MeSH])” 16 studies were assessed eligibility. One small, retrospective evaluated using univariate analysis 61 episodes [[4]Sandoe J.A.T. Witherden I.R. Au-Yeung H.-K.C. Kite P. Kerr K.G. Wilcox M.H. infection: management outcome consecutive cases.J Antimicrob Chemother. 2002; 50: 577-582https://doi.org/10.1093/jac/dkf182Crossref (52) In that study, did not have significant impact cure, failure, relapse infection. Moreover, 111 show statistically association between antibiotic mortality [[5]Marschall Piccirillo M.L. Fraser V.J. Doherty J.A. Warren D.K. Catheter removal versus retention catheter-associated infections.Can J Infect Med Microbiol. 2013; 24: e83-e87Crossref (15) Thus, date, catheter based opinion. general, national international statements (summarized Table recommend short course (5–14 days) antibiotics infections, especially context Nevertheless, further are needed investigate this unresolved issue. interim, we would prefer discourage clinicians from administering (>14 without evidence endocarditis Last, remind readers World Antimicrobial Awareness Week (18th–24th November) reducing important step towards stewardship. SM NB wrote first version letter. review. All approved final The disclosed they any conflicts interest. Dr Timsit received fees lectures MSD, Pfizer, 3M Biomerieux, research grants Astellas , 3M, MSD Pfizer he participated advisory boards Bayer Pharma, Nabriva, Pfizer. Leonard Mermel served as consultant Citius Pharmaceuticals, Marvao Medical, Leonard-Meron Biosciences, Destiny Nobio. Buetti receiving Mobility grant Swiss National Science Foundation (grant number: P4P4PM_194449 ). fellowship supported by bacteraemia?Clinical Microbiology InfectionVol. 27Issue 3PreviewEnterococcal (EB) common, particularly nosocomial setting, its poses challenge microbiologists. Full-Text PDF Re: Treatment infections—authors’ replyClinical 3PreviewIn their letter concerning [1], Muff colleagues correctly point out it debateable whether 14 more should be treat (CREB) absence complications. They also highlight support non-complicated CREB weak, therefore such relies mainly opinion, statement completely agree reflected conclusions [2].