我们的目的是调查肠球菌对复杂性尿路感染 (cUTI) 病例初始抗生素治疗 (IAT) 失败和住院时间延长的影响，并确定肠球菌 cUTI 的危险因素。对成人 cUTI 患者进行分析，比较肠球菌之间的差异和非肠球菌群。采用单变量和多变量分析来确定独立危险因素。这项研究包括 419 名患者，与非肠球菌组相比，肠球菌组显示出显着较高的 IAT 失败率和平均住院时间延长 4.4 天。多变量分析确定肠球菌、医院获得性尿路感染 (HA-UTI)、留置导尿管和卧床休息（卧床不起）是 IAT 失败的独立危险因素。肠球菌与住院时间延长显着相关，其他独立危险因素包括 IAT 失败、既往使用抗菌药物、年龄调整的查尔森合并症指数 (ACCI) ≥ 4、低白蛋白血症和卧床休息。泌尿系癌症、HA-UTI、留置导尿管、尿潴留和泌尿外科手术是肠球菌性 cUTI 的危险因素。我们提供了第一个证据，证明肠球菌独立增加 cUTI 成人 IAT 失败和延长住院时间的风险，强调了及时诊断的重要性确定优化措施，包括抗生素治疗方案。肠球菌 cUTI 的危险因素也已被确定，以帮助临床医生管理这种疾病。© 2024。Springer-Verlag GmbH 德国，Springer Nature 旗下公司。

We aimed to investigate the impact of enterococci on initial antibiotic treatment (IAT) failure and prolonged hospitalization in complicated urinary tract infection (cUTI) cases, and to identify risk factors for enterococcal cUTI.Adult cUTI patients were analyzed to compare the differences between the Enterococcus and non-Enterococcus groups. Univariate and multivariate analyses were employed to identify independent risk factors.This study included 419 patients, with the Enterococcus group showing significantly higher IAT failure rates and an extended average length of stay by 4.4 days compared to the non-Enterococcus group. Multivariate analysis identified enterococci, hospital-acquired UTIs (HA-UTI), indwelling catheters, and bed rest (bedridden) as independent risk factors for IAT failure. Enterococci were notably linked to prolonged hospitalization, other independent risk factors included IAT failure, prior antimicrobial use, age-adjusted Charlson comorbidity index (ACCI) ≥ 4, hypoalbuminemia, and bed rest. Urological cancer, HA-UTI, indwelling catheters, urinary retention, and urologic surgery were risk factors for enterococcal cUTI.We provide the first evidence that enterococci independently increase the risk for IAT failure and prolonged hospitalization in adults with cUTIs, highlighting the significance of timely identification to optimize measures including antibiotic regimens. Risk factors for enterococcal cUTI have also been identified to aid clinicians in managing this condition.© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.