Over the past two decades Enterococcus faecalis and Enterococcus faecium have become increasingly important pathogens worldwide, especially due to hospital-acquired infections. Enterococcus spp. are rated as the third leading cause of hospital-acquired bacteraemia in the United States and account for 9.4% of the bacteraemias [ 1 x 1 Wisplinghoff, H, Bischoff, T, Tallent, SM, Seifert, H, Wenzel, RP, Edmond, MB et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004; 39: 309–317 Crossref | PubMed | Scopus (2570) | Google Scholar See all References 1 ]. Consistent with this, an Italian multicentre study reported enterococci in 11.4% of all bacteraemias during a 1-year survey [ 2 x 2 Luzzaro, F, Ortisi, G, Larosa, M, Drago, M, Brigante, G, Gesu, G et al. Prevalence and epidemiology of microbial pathogens causing bloodstream infections: results of the OASIS multicenter study. Diagn Microbiol Infect Dis. 2011; 69: 363–369 Abstract | Full Text | Full Text PDF | PubMed | Scopus (41) | Google Scholar See all References 2 ]. Similarly, Danish surveillance data demonstrated rising incidences of E. faecalis and E. faecium bacteraemia, with increases from 2002 to 2009 of 51% and 201%, respectively [ 3 x 3 DANMAP 2009-Use of antimicrobial agents and occurrence af antimicrobial resistance in bacteria from food animals, foods and humans in Denmark. Available at: www.danmap.org; 2010. Google Scholar See all References , 4 x 4 Lester, CH, Sandvang, D, Olsen, SS et al. Emergence of ampicillin-resistant Enterococcus faecium in Danish hospitals. J Antimicrob Chemother. 2008; 62: 1203–1206 Crossref | PubMed | Scopus (45) | Google Scholar See all References ]. Enterococci are generically resistant to all cephalosporins and clinical use of carbapenems and fluoroquinolones is not recommended as first-line treatment. In addition, acquired resistance to penicillins, aminoglycosides and glycopeptides has increased (www.ecdc.europa.eu/en/activities/surveillance/EARS-Net). The 30-day mortality of enterococcal bacteraemia is above 25% for vancomycin-susceptible strains [ 5 x 5 Bhavnani, SM et al. A nationwide, multicenter, case-control study comparing risk factors, treatment, and outcome for vancomycin-resistant and -susceptible enterococcal bacteremia. Diagn Microbiol Infect Dis. 2000; 36: 45–58 Abstract | Full Text | Full Text PDF | Scopus (138) | Google Scholar See all References , 6 x 6 McBride, SJ, Upton, A, Roberts, SA et al. Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia – a five-year retrospective review. Eur J Clin Microbiol Infect Dis. 2010; 29: 107–114 Crossref | PubMed | Scopus (34) | Google Scholar See all References , 7 x 7 Suppli, M, Aabenhus, R, Harboe, ZB, Andersen, LP, Tvede, M, Jensen, JU et al. Mortality in enterococcal bloodstream infections increases with inappropriate antimicrobial therapy. Clin Microbiol Infect. 2011; 17: 1078–1083 Abstract | Full Text | Full Text PDF | PubMed | Scopus (31) | Google Scholar See all References ] and above 45% for resistant strains [ 5 x 5 Bhavnani, SM et al. A nationwide, multicenter, case-control study comparing risk factors, treatment, and outcome for vancomycin-resistant and -susceptible enterococcal bacteremia. Diagn Microbiol Infect Dis. 2000; 36: 45–58 Abstract | Full Text | Full Text PDF | Scopus (138) | Google Scholar See all References , 8 x 8 Han, SH, Chin, BS, Lee, HS et al. Vancomycin-resistant enterococci bacteremia: risk factors for mortality and influence of antimicrobial therapy on clinical outcome. J Infect. 2009; 58: 182–190 Abstract | Full Text | Full Text PDF | PubMed | Scopus (27) | Google Scholar See all References ].

Invasive disease as a result of Campylobacter is rarely reported. We reviewed 46 cases of blood stream infection with Campylobacter in a Danish population with complete follow-up. The incidence was 2.9 per 1 million person-years with a peak incidence in the age group above 80 years. In the population, the ratio of notified bacteraemia/enteritis patients with Campylobacter infection was 0.004. Patients with bacteraemia were older and had higher comorbidity, e.g. alcoholism, immunosuppression, previous gastrointestinal surgery or HIV infection. We found 26% of blood isolates resistant to ciprofloxacin. The length of hospitalization was significantly longer in bacteraemia patients, whereas the outcome was favourable with 28-day mortality of 4% in bacteraemia patients and 1% in enteritis patients. None of the bacteraemia patients relapsed within 365-day follow-up.