Impact of vancomycin resistance in Enterococcus faecium bloodstream infection on mortality: A retrospective analysis of nationwide surveillance data.
Int J Infect Dis
; 134: 8-14, 2023 Sep.
Article
de En
| MEDLINE
| ID: mdl-37172775
ABSTRACT
OBJECTIVES:
It is unclear whether the poor outcome of patients with severe vancomycin-resistant enterococci (VRE) infection is attributable to vancomycin resistance or to Enterococcus faecium (Efm), which predominates among VRE.METHODS:
Retrospective study of a prospectively identified cohort from nationwide surveillance. A cohort of consecutive, nonduplicate episodes of monomicrobial bloodstream infections (BSIs) caused by Efm in 2016 was selected. The primary outcome was all-cause, 30-day, in-hospital mortality. Inverse probability weighting was applied using the propensity score for vancomycin-resistant Efm (VREfm) BSI.RESULTS:
A total of 241 Efm BSI episodes were included, of which 59 (24.5%) were VREfm. Patients with VREfm BSI were younger but had similar comorbidities to those with vancomycin-sensitive Efm (VSEfm) BSI. Multivariable logistic regression revealed that younger age, previous piperacillin-tazobactam use, and steroid use were significant risk factors for VREfm BSI, but 30-day in-hospital mortality did not differ significantly between groups (35.6% and 23.6% for VREfm and VSEfm, respectively; odds ratio, 1.79; 95% confidence interval, 0.95-3.37; P = 0.101). However, Cox regression with inverse probability weighting revealed that vancomycin resistance was independently associated with an increased risk of mortality (adjusted hazard ratio, 2.18; 95% confidence interval, 1.03-4.62; P = 0.041).CONCLUSION:
In patients with Efm BSI, vancomycin resistance was independently associated with mortality.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Infections bactériennes à Gram positif
/
Enterococcus faecium
/
Bactériémie
/
Sepsie
/
Entérocoques résistants à la vancomycine
Type d'étude:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limites:
Humans
Langue:
En
Journal:
Int J Infect Dis
Sujet du journal:
DOENCAS TRANSMISSIVEIS
Année:
2023
Type de document:
Article