Clinical Outcomes for Patients with Bacteremia Caused by Vancomycin?Resistant Enterococcus in a Level 1 Trauma Center
Open Access
- 1 April 2002
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 34 (7), 922-929
- https://doi.org/10.1086/339211
Abstract
To assess the degree of morbidity and mortality attributable to vancomycin resistance in enterococcal bacteremia (EB), a matched case-control study was conducted. Patients with bacteremia due to vancomycin-resistant enterococcus (VRE) were matched to control patients with bacteremia due to vancomycin-susceptible enterococcus. During 1996–2000, 65 patients with cases of clinically significant VRE bacteremia were identified, and 53 of these patients were successfully matched. In this group of patients, VRE bacteremia was found to be an independent predictor of crude mortality (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.2–13.3) and the infection-related mortality rate (OR, 5.2; 95% CI, 1.4–20.0). It was also an independent predictor of the rate of clinical failure at day 7 after the onset of EB (OR, 4.6; 95% CI, 1.2–17.3) and overall clinical failure (OR, 4.3; 95% CI, 1.3–14.5) and was associated with a longer mean length of hospitalization after the onset of EB, compared with that for control patients (22.7 ± 1.88 vs. 15.9 ± 1.7, P = .006). These observations indicate that vancomycin resistance in EB independently affects outcomes.Keywords
This publication has 21 references indexed in Scilit:
- Enterococcus faecium BacteremiaArchives of Internal Medicine, 1998
- Nosocomial enterococcal blood stream infections in the SCOPE program: Antimicrobial resistance, species occurrence, molecular testing results, and laboratory testing accuracyDiagnostic Microbiology and Infectious Disease, 1997
- Enterococcal Bacteremia in the Surgical Intensive Care UnitArchives of Surgery, 1997
- Vancomycin-Resistant Enterococcal Bacteremia: Natural History and Attributable MortalityClinical Infectious Diseases, 1996
- Risk Factors Associated with Vancomycin-Resistant Enterococcus faecium Infection or Colonization in 145 Matched Case Patients and Control PatientsClinical Infectious Diseases, 1996
- Nosocomial Infections with Vancomycin-Resistant Enterococcus fuecium in Liver Transplant Recipients: Risk Factors for Acquisition and MortalityClinical Infectious Diseases, 1996
- Risk Factors for Mortality Associated with Enterococcal Bloodstream InfectionsInfection Control & Hospital Epidemiology, 1996
- Differences in Outcomes for Patients with Bacteremia Due to Vancomycin-Resistant Enterococcus faecium or Vancomycin-Susceptible E. faeciumClinical Infectious Diseases, 1996
- Enterococcus faecium and Enterococcus faecalis Bacteremia: Acquisition and OutcomeClinical Infectious Diseases, 1995
- Plasmid-Mediated Resistance to Vancomycin and Teicoplanin in Enterococcus FaeciumNew England Journal of Medicine, 1988