Clinical and microbiological characteristics of vancomycin-resistant Enterococcus faecium bloodstream infection in Central Taiwan. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: Chen, Chang-Hua; Lin, Li-Chen; Chang, Yu-Jun; Chang, Chih-Yen
• Other Names: Hospenthal. Duane R. section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: bloodstream infection -- Enterococcus faecium -- mortality -- multilocus sequence typing -- vancomycin-resistant enterococci; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009000
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Bloodstream infections (BSIs) due to vancomycin-resistant Enterococcus faecium (VRE fae ) remain a therapeutic challenge. This study aimed to evaluate mortality from BSIs due to VRE fae in Central Taiwan. We retrospectively analyzed patients with significant VRE fae BSIs in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2014. Of the 152 patients with Enterococcal BSI, 56 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI and 20 (13.2%) patients were associated with polymicrobial bacteremia. VRE fae BSI was observed in 36 (23.7%) patients. Van A (100%) is the prevalence genotype, and ST 17 (41.7%) is the predominant ST type among 36 VRE fae isolates during the study period. The 30-day mortality rate was 13.2% (20/152). The multivariate logistic regression analysis showed that the onset of VRE fae BSI in the ICU (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 1.7–10.0, P = .002) was a significant risk factor for 30-day mortality, whereas an appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14–0.79, P = .013). Our results underscore the need to assist patients who are admitted to ICUs with VRE fae BSIs. We emphasize the use of an appropriate antimicrobial therapy for VRE fae BSI with the aim to treat more patients with these infections. Abstract : Supplemental Digital Content is available in the text