Learn about Enterococcus faecium infection diagnosis, including E. faecium infection clinical documentation and medical coding. Find information on Enterococcal infection and VRE infection healthcare guidelines for accurate diagnosis and treatment. This resource offers insights for clinicians and healthcare professionals dealing with Enterococcus faecium infections.
Also known as
Sepsis due to Enterococcus faecium
Sepsis caused by the bacterium Enterococcus faecium.
Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere
Infections caused by Streptococcus, Staphylococcus, or Enterococcus affecting other body systems.
Certain infectious and parasitic diseases
Encompasses various infectious and parasitic diseases, including some enterococcal infections.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the Enterococcus faecium infection confirmed?
Yes
Is the infection site specified?
No
Do not code Enterococcus faecium infection. Code the presenting symptoms or suspected diagnosis.
When to use each related code
| Description |
|---|
| Infection caused by E. faecium bacteria. |
| Infection by other Enterococcus species (not faecium). |
| Bacterial infection resistant to vancomycin. |
Coding E. faecium infection requires specifying the infection site (e.g., urinary tract, bloodstream). Unspecified site leads to coding errors and claim rejections.
Not all E. faecium are vancomycin-resistant (VRE). Incorrectly coding VRE increases costs and impacts antibiotic stewardship data.
Insufficient clinical documentation to support the E. faecium diagnosis can lead to coding queries, denials, and compliance issues.
Q: What are the most effective empiric antibiotic treatment options for suspected Vancomycin-Resistant Enterococcus faecium (VRE) bacteremia in critically ill patients?
A: Empiric antibiotic therapy for suspected VRE bacteremia in critically ill patients is crucial due to the high mortality risk. While awaiting susceptibility testing, consider linezolid or daptomycin as first-line options. Linezolid provides excellent tissue penetration but carries risks of thrombocytopenia and peripheral neuropathy with prolonged use. Daptomycin, a bactericidal lipopeptide, is effective against most VRE strains, but its efficacy is reduced in the presence of pulmonary surfactant. For patients with concurrent meningitis, daptomycin is not recommended due to its poor penetration into the cerebrospinal fluid. Explore how newer agents like quinupristin-dalfopristin or tigecycline may be considered in specific circumstances or as part of combination therapy after susceptibility results are available. Always consult local antibiograms and infectious disease specialist guidance to tailor treatment for optimal outcomes. Consider implementing a rapid diagnostic test to guide antibiotic de-escalation or streamline therapy once VRE is confirmed.
Q: How can I differentiate between colonization and true infection with Enterococcus faecium in patients with positive cultures from urine or surveillance swabs?
A: Distinguishing between colonization and true infection with Enterococcus faecium is critical to avoid unnecessary antibiotic use and minimize the selection pressure for resistance. Positive cultures from urine or surveillance swabs, particularly in hospitalized patients, may represent colonization rather than true infection. In urine cultures, a colony count greater than 10^5 CFU/mL often suggests infection, especially in symptomatic patients. However, lower colony counts may still represent infection in certain settings, such as the presence of indwelling catheters or immunosuppression. For surveillance swabs (e.g., rectal), a positive result typically indicates colonization. Correlating culture results with clinical signs and symptoms like fever, chills, localized pain, or purulent drainage is crucial. Consider implementing a diagnostic stewardship program that incorporates clinical criteria and laboratory findings to guide the management of patients with positive Enterococcus faecium cultures. Learn more about the McGeer criteria and other validated tools that can help distinguish colonization from infection.
Patient presents with signs and symptoms suggestive of Enterococcus faecium infection. Clinical presentation includes [specific symptoms documented e.g., fever, chills, urinary urgency, dysuria, wound infection, redness, swelling, tenderness, hypotension, tachycardia]. Based on patient history, physical examination, and laboratory findings, the diagnosis of E. faecium infection is suspected. Differential diagnoses considered include other bacterial infections, such as Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. Laboratory tests ordered include urine culture, blood culture, wound culture, and complete blood count (CBC) with differential. Vancomycin-resistant Enterococcus (VRE) screening will be performed. Preliminary treatment initiated with [mention antibiotic therapy e.g., ampicillin, vancomycin] pending culture and sensitivity results. Patient education provided on infection control precautions, medication adherence, and potential complications. The patient's condition will be closely monitored for response to therapy and development of any complications, such as sepsis or endocarditis. ICD-10 code [appropriate ICD-10 code, e.g., B95.2] is considered. Further investigations and treatment adjustments will be made based on clinical response and laboratory findings. Plan for follow-up care discussed.