Enterococcus faecium Bacteremia

Stosor, Valentina; Peterson, Lance R.; Postelnick, Michael; Noskin, Gary A.

doi:10.1001/archinte.158.5.522

Cited by 162 publications

(24 citation statements)

References 27 publications

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“…Similar to studies that demonstrated VRE bacteraemia was associated with exposure of patients to VRE contaminated ‘exogenous’ sources [16,31], urinary catheter use was independently associated with the development of VRE bacteraemia. The need for a urinary catheter may also be an indicator of severe underlying illness [16].…”

Section: Discussionsupporting

confidence: 75%

“…In the present study, duration of therapy with specific antibiotics was considered, unlike many earlier studies [12,13,16,17,19-22,24,27,28,30]. Exposure to anti-anaerobic antibiotics has been linked to VRE gastrointestinal tract colonisation [45] and bacteraemia [10,46]; however, the VRE genotype was either vanA VRE [10,46] or not determined [45].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, studies [4,23,25-27] that have included both colonised and infected patients as their VRE cases should be interpreted with care. Case–control studies [4,11-14,16,17,19,25] comparing VRE to VSE bacteraemia patients may not accurately account for the impact of vancomycin use; this bias is minimised with a case-case-control study that compares VRE bacteraemia patients to controls without enterococcal bacteraemia and VSE bacteraemia patients to controls [33]. Of the two studies involving predominantly vanB genotype [30,31], only one [31] was a case-case-control study which used the same control patients for both case groups, thereby enabling meaningful characterisation of the distinct features of bacteraemia specific to the resistant and susceptible enterococci [33].…”

Section: Introductionmentioning

confidence: 99%

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Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

et al. 2014

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BackgroundEnterococci are a major cause of healthcare-associated infection. In Australia, vanB vancomycin-resistant enterococci (VRE) is the predominant genotype. There are limited data on the factors linked to vanB VRE bacteraemia. This study aimed to identify factors associated with vanB VRE bacteraemia, and compare them with those for vancomycin-susceptible enterococci (VSE) bacteraemia.MethodsA case-case-control study was performed in two tertiary public hospitals in Victoria, Australia. VRE and VSE bacteraemia cases were compared with controls without evidence of enterococcal bacteraemia, but may have had infections due to other pathogens.ResultsAll VRE isolates had vanB genotype. Factors associated with vanB VRE bacteraemia were urinary catheter use within the last 30 days (OR 2.86, 95% CI 1.09-7.53), an increase in duration of metronidazole therapy (OR 1.65, 95% CI 1.17-2.33), and a higher Chronic Disease Score specific for VRE (OR 1.70, 95% CI 1.05-2.77). Factors linked to VSE bacteraemia were a history of gastrointestinal disease (OR 2.29, 95% CI 1.05-4.99) and an increase in duration of metronidazole therapy (OR 1.23, 95% CI 1.02-1.48). Admission into the haematology/oncology unit was associated with lower odds of VSE bacteraemia (OR 0.08, 95% CI 0.01-0.74).ConclusionsThis is the largest case-case-control study involving vanB VRE bacteraemia. Factors associated with the development of vanB VRE bacteraemia were different to those of VSE bacteraemia.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

et al. 2014

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“…One study has shown the cost of bacteraemia due to GRE to be $27 000 higher than that due to glycopeptide-sensitive enterococci. 110 As with all other infection control interventions, the quality of clinical care must not suffer as a result of the precautions implemented. Due to the uncertainty surrounding the management of GRE, discussion between the infection control team and the clinical staff is essential.…”

Section: Infection Control Measures Principles Of Outbreak Managementmentioning

confidence: 99%

Guidelines for the control of glycopeptide-resistant enterococci in hospitals

Cookson¹,

Macrae

Barrett

et al. 2006

Journal of Hospital Infection

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“…Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended spectrum β-lactamase-producing bacteria (ESBL), multi-drug resistance in Mycobacterium tuberculosis (MDRTB) strains as well as multi-drug resistant Gram-negative bacteria are seen in postoperative surgical patients. Although the data are conflicting, some clues hint at a higher infection-related mortality associated with these resistant organisms [24,25,26,27,28]. …”

Section: Therapy Of Postoperative Bacterial/fungal Infectionsmentioning

confidence: 99%

Postoperative Bacterial/Fungal Infections: A Challenging Problem in Critically Ill Patients after Abdominal Surgery

Lichtenstern

Schmidt²,

Knaebel³

et al. 2007

Dig Surg

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Critically ill patients after extended surgical procedures are at high risk for postoperative infections. The overall incidence of sepsis increased constantly over the last decade, whereas sepsis-related mortality decreased, due to new intensive care options. After extended intra-abdominal surgery the abdomen is the predominant focus of sepsis, followed by respiratory tract infections. Unspecific clinical signs lead to the diagnosis of postoperative sepsis. Early focus identification by clinical, laboratory and radiologic examination is of major importance for a promising therapy, followed by immediately initiated procedures for source control and an adequate anti-infective drug therapy. For nosocomial sepsis, the use of antimicrobial regimens with extended spectra and potent activity against both Gram-negative and Gram-positive bacterial pathogens are warranted. Fungal infections play a great role for immunocompromized patients, e.g. after solid organ transplantation or under chronic corticoid therapy. An increasing incidence of multi-drug resistance in bacterial and fungal isolates has been observed in the last years. This is becoming a growing problem also for critically ill patients after abdominal surgery. Standardized treatment protocols including supportive and adjunctive therapy and the use of modern anti-infective agents may lead to a decrease in postoperative mortality due to sepsis.

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Enterococcus faecium Bacteremia

Abstract: Vancomycin-resistant E faecium bacteremia is a complication of prolonged hospitalization in debilitated patients. Vancomycin resistance has a negative impact on survival in patients with E faecium bacteremia and leads to higher health care costs.

Cited by 162 publications

References 27 publications

Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

Case-case-control study on factors associated with vanB vancomycin-resistant and vancomycin-susceptible enterococcal bacteraemia

Guidelines for the control of glycopeptide-resistant enterococci in hospitals

Postoperative Bacterial/Fungal Infections: A Challenging Problem in Critically Ill Patients after Abdominal Surgery

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