Observational study of the epidemiology and outcomes of vancomycin-resistantEnterococcusbacteraemia treated with newer antimicrobial agents
Open Access
- 15 November 2010
- journal article
- research article
- Published by Cambridge University Press (CUP) in Epidemiology and Infection
- Vol. 139 (9), 1342-1350
- https://doi.org/10.1017/s0950268810002475
Abstract
Vancomycin-resistant Enterococcus bloodstream infections (VRE-BSI) are a growing problem with few clinical trials to guide therapy. We conducted a retrospective study of management and predictors of mortality for VRE-BSI at a tertiary-care centre from January 2005 to August 2008. Univariate and multivariable analyses examined the relationship of patient characteristics and antibiotic therapy with 30-day all-cause mortality. Rates of VRE-BSI increased from 0·06 to 0·17 infections/1000 patient-days (P=0·03). For 235 patients, 30-day mortality was 34·9%. Patients were primarily treated with linezolid (44·2%) or daptomycin (36·5%). Factors associated with mortality were haemodialysis [odds ratio (OR) 3·2, 95% confidence interval (CI) 1·6–6·3, P=0·007], mechanical ventilation (OR 3·7, 95% CI 1·3–10·4, P=0·01), and malnutrition (OR 2·0, 95% CI 1·0–4·0, P=0·046). Use of linezolid, but not daptomycin (P=0·052) showed a trend towards an association with survival. In conclusion, VRE-BSI is a growing problem, associated with significant 30-day mortality. Multiple factors were associated with poor outcomes at our hospital.Keywords
This publication has 34 references indexed in Scilit:
- Daptomycin for the treatment of enterococcal bacteraemia: results from the Cubicin® Outcomes Registry and Experience (CORE)International Journal of Antimicrobial Agents, 2009
- Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of AmericaClinical Infectious Diseases, 2009
- Daptomycin in endocarditis and bacteraemia: a British perspectiveJournal of Antimicrobial Chemotherapy, 2008
- Clinical experience with daptomycin: bacteraemia and endocarditisJournal of Antimicrobial Chemotherapy, 2008
- The burden of vancomycin-resistant enterococcal infections in US hospitals, 2003 to 2004Diagnostic Microbiology and Infectious Disease, 2008
- CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care settingAmerican Journal of Infection Control, 2008
- Daptomycin in the treatment of vancomycin-resistant Enterococcus faecium bacteremia in neutropenic patientsJournal of Infection, 2007
- Consequences of vancomycin‐resistant Enterococcus in liver transplant recipients: a matched control studyClinical Transplantation, 2005
- Initial management of candidemia at an academic medical center: Evaluation of the IDSA guidelinesDiagnostic Microbiology and Infectious Disease, 2005
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987