What is the recommended treatment for Enterococcus (E) faecalis catheter-associated bloodstream infection (CBP)?

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Treatment of Enterococcus faecalis Catheter-Associated Bloodstream Infection

For Enterococcus faecalis catheter-associated bloodstream infection (CRBSI), ampicillin is the drug of choice for ampicillin-susceptible isolates, with vancomycin reserved for ampicillin-resistant strains, and removal of infected short-term catheters is recommended. 1

Initial Management

  • Remove infected short-term intravascular catheters 1
  • For infected long-term catheters, removal is indicated in cases of:
    • Insertion site or pocket infection
    • Suppurative thrombophlebitis
    • Sepsis
    • Endocarditis
    • Persistent bacteremia
    • Metastatic infection 1

Antimicrobial Therapy

First-line options:

  • Ampicillin-susceptible E. faecalis: Ampicillin is the drug of choice 1
  • Ampicillin-resistant E. faecalis: Vancomycin should be used 1
  • Ampicillin and vancomycin-resistant E. faecalis: Linezolid or daptomycin based on susceptibility results 1

Dosing considerations for resistant strains:

  • For vancomycin-resistant enterococci in dialysis patients: daptomycin 6 mg/kg after each dialysis session or oral linezolid 600 mg every 12 hours 1
  • Higher daptomycin doses (≥9 mg/kg) have shown more rapid bacterial clearance than conventional doses (6-9 mg/kg) 2
  • Recent evidence suggests doses ≥11 mg/kg may improve survival in vancomycin-resistant enterococcal bloodstream infections, particularly for isolates with higher MICs 3

Duration of Therapy

  • 7-14 days for uncomplicated enterococcal CRBSI when:
    • Short-term catheter is removed, OR
    • Long-term catheter is retained with antibiotic lock therapy 1, 4
  • Extended therapy (4-6 weeks) for complicated cases with:
    • Endocarditis
    • Suppurative thrombophlebitis
    • Persistent bacteremia 1

Adjunctive Therapy

  • If long-term catheter is retained, antibiotic lock therapy should be used in addition to systemic therapy 1
  • For patients with retained catheters, obtain follow-up blood cultures and remove catheter if bacteremia persists >72 hours after initiating appropriate antibiotics 1

Monitoring for Complications

  • Perform transesophageal echocardiography (TEE) if:
    • Signs/symptoms suggest endocarditis (new murmur, embolic phenomena)
    • Prolonged bacteremia or fever despite appropriate therapy (>72 hours)
    • Radiographic evidence of septic pulmonary emboli
    • Presence of prosthetic valve or other endovascular foreign bodies 1

Role of Combination Therapy

  • The role of combination therapy (cell wall-active agent plus aminoglycoside) for enterococcal CRBSI without endocarditis remains unresolved 1
  • Some evidence suggests combination therapy with gentamicin and ampicillin may be more effective than monotherapy when catheter is retained 1
  • Alternative combination: ampicillin plus high-dose ceftriaxone has been used successfully when aminoglycosides cannot be used due to resistance or nephrotoxicity 1

Special Considerations

  • Enterococcal bacteremia persisting >4 days is independently associated with increased mortality 1
  • Monitor for creatine kinase elevation with high-dose daptomycin therapy; higher rates of elevation (>2000 U/L) have been reported with doses ≥11 mg/kg (3.9%) compared to 8-<11 mg/kg (1.1%) 3
  • EUCAST has noted insufficient evidence for daptomycin breakpoints for Enterococcus species, recommending increased vigilance when using high-dose daptomycin 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Duración del Tratamiento Antibiótico en Casos de Bacteriemia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Daptomycin in the treatment of enterococcal bloodstream infections and endocarditis: a EUCAST position paper.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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