Comparison of the Clinical Characteristics and Outcomes Associated with Vancomycin-resistant Enterococcus Faecalis and Vancomycin-resistant E. Faecium Bacteremia

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 2012 Feb 23

PMID 22354290

Citations 21

Authors

Kayoko Hayakawa

Dror Marchaim

Emily T Martin

Namita Tiwari

Adnan Yousuf

Bharath Sunkara

Harish Pulluru

Harikrishna Kotra

Asma Hasan

Suchitha Bheemreddy

Puja Sheth

Dae-Won Lee

Srinivasa Kamatam

Pradeep Bathina

Priyanka Nanjireddy

Indu K Chalana

Satyam Patel

Sarwan Kumar

Amit Vahia

Kimberly Ku

Victoria Yee

Jessie Swan

Jason M Pogue

Paul R Lephart

Michael J Rybak

Keith S Kaye

Affiliations

Soon will be listed here.

Abstract

In published studies, cohorts of patients with bacteremia due to vancomycin-resistant Enterococcus (VRE) have predominantly been infected with Enterococcus faecium. Little is known about the epidemiology and outcomes associated with bacteremia due to VR Enterococcus faecalis. A retrospective study of isolates obtained from January 2008 to October 2010 was conducted at Detroit Medical Center (DMC). Unique patients with blood cultures positive for VRE were reviewed. Outcomes were analyzed using logistic regression. During the study period, 105 cases of bacteremia due to VR E. faecalis and 197 cases of bacteremia due to VR E. faecium were identified. The mean age in the study cohort was 61.5 ± 15 years; 162 subjects (53.6%) were male. After controlling for a propensity score, bacteremia due to VR E. faecalis was associated with >2-fold-lower in-hospital mortality than bacteremia due to VR E. faecium. Interestingly, bacteremia due to VR E. faecalis was associated with longer hospital stay after VRE isolation, although total length of stay was similar for groups with VR E. faecalis and VR E. faecium. Bacteremia due to VR E. faecalis was associated with a >2-fold-lower risk for mortality than bacteremia due to VR E. faecium, possibly due to the availability of β-lactam therapeutics for treatment of VR E. faecalis.

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