Comparison of Mortality Associated with Vancomycin-Resistant and Vancomycin-Susceptible Enterococcal Bloodstream Infections: A Meta-analysis

DiazGranados, Carlos A.; Zimmer, Shanta M.; Klein, Mitchel; Jernigan, John A.

doi:10.1086/430909

Cited by 412 publications

(277 citation statements)

References 44 publications

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“…This is in contrast to the increased mortality reported among adults with VRE BSI. 10,47 This difference in VRE outcomes may be because our study evaluated all VRE infections, including less invasive infections of the urinary tract and skin and soft tissue infections. However, a study comparing 39 children with VRE BSI to 339 with vancomycin-susceptible Enterococcus BSI also found no statistically significant difference in mortality between groups.…”

Section: Discussionmentioning

confidence: 99%

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Adams

Eberly

Goudie

et al. 2016

Hospital Pediatrics

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A B S T R A C T OBJECTIVE:Vancomycin-resistant Enterococcus (VRE) is an emerging drug-resistant organism responsible for increasing numbers of nosocomial infections in adults. Few data are available on the epidemiology and impact of VRE infections in children. We hypothesized a significant increase in VRE infections among hospitalized children. Additionally, we predicted that VRE infection would be associated with certain comorbid conditions and increased duration and cost of hospitalization. METHODS:A retrospective study of inpatient pediatric patients was performed using data on hospitalizations for VRE from the Healthcare Cost and Utilization Project Kids' Inpatient Database from 1997 to 2012. We used a multivariable logistic regression model to establish factors associated with VRE infection and a high-dimensional propensity score match to evaluate death, length of stay, and cost of hospitalization. RESULTS: Hospitalizations for VRE infection showed an increasing trend, from 53 hospitalizationsper million in 1997 to 120 in 2012 (P , .001). Conditions associated with VRE included Clostridium difficile infection and other diagnoses involving immunosuppression and significant antibiotic and health care exposure. Patients with VRE infection had a significantly longer length of stay (attributable difference [AD] 2.1 days, P , .001) and higher hospitalization costs (AD $8233, P 5 .004). VRE infection was not associated with an increased risk of death (odds ratio 1.03; 95% confidence interval 0.73-1.47).CONCLUSIONS: VRE infections among hospitalized children are increasing at a substantial rate. This study demonstrates the significant impact of VRE on the health of pediatric patients and highlights the importance of strict adherence to existing infection control policies and VRE surveillance in certain high-risk pediatric populations.

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Section: Discussionmentioning

confidence: 99%

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Adams

Eberly

Goudie

et al. 2016

Hospital Pediatrics

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“…B. Harnwegsinfektionen, Wundinfektionen (insbesondere im Abdominalbereich, oft auch polymikrobiell), Peritonitiden oder auch schwere Infektionen wie Bakteriä-mien/Septikämien und Endokarditiden. Die Enterokokkenseptikämien gelten als besonders schwerwiegend, ihre Gesamtmortalitätsraten werden mit 28-58% und die direkten Mortalitätsraten mit 31% angegeben [5,6,7,8,9,10,11,12,13] . Die genannten Infektionen können vor allem bei Früh-und Neugeborenen, bei älteren Personen sowie bei Patienten mit einem Grundleiden und/oder mit einer Immunsuppression auftreten.…”

Section: Die Gattung Enterococcusunclassified

Vancomycin-resistente Enterokokken (VRE)

Klare

Witte

Wendt³

et al. 2012

Bundesgesundheitsbl.

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“…5 While the various agents including quinupristindalfopristin, daptomycin, and tigecyline are being used for VRE infections in adults, limited treatment options are significant problems for children. The clinical cure rate of infections with antibiotic resistant gram-positive pathogens was reported as 69.7% in children treated with linezolid.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-resistant Enterococcus bacteremia in a child with acute myeloid leukemia: Successful treatment with daptomycin

et al. 2016

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Multiple-drug-resistant enterococcal infections can be a serious problem in pediatric patients particularly concomitance with severe underlying diseases and lead to significant morbidity and mortality. The treatment options in children are limited compared with adults. We report a 3-year old-boy with acute myeloid leukemia (AML)-M7 and vancomycin-resistant enterococcus bacteremia successfully treated with daptomycin. Daptomycin may be an alternative therapy for VRE infections in children; more studies are needed for extended usage. BACKGROUNDVancomycin-resistant Enterococcus (VRE) infections is a global clinical problem at the hospital settings and can cause infective endocarditis, catheter-related bloodstream infections, urinary tract infections and bacteremia of unknown source. VRE bacteremia is a major cause of nosocomial infections with a significant morbidity and mortality especially in children with underlying severe chronic diseases.

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Comparison of Mortality Associated with Vancomycin-Resistant and Vancomycin-Susceptible Enterococcal Bloodstream Infections: A Meta-analysis

Abstract: Vancomycin resistance is independently associated with increased mortality among patients with enterococcal bloodstream infection.

Cited by 412 publications

References 44 publications

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Vancomycin-resistente Enterokokken (VRE)

Vancomycin-resistant Enterococcus bacteremia in a child with acute myeloid leukemia: Successful treatment with daptomycin

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