Identification of temporal clusters and risk factors of bacteremia by nosocomial vancomycin-resistant enterococci

Silva, Natal Santos da; Muniz, Vitor Dantas; Estofolete, Cássia Fernanda; Furtado, Guilherme Henrique Campos; Rubio, Fernando Gôngora

doi:10.1016/j.ajic.2013.11.010

Cited by 21 publications

(15 citation statements)

References 14 publications

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“…To focus on this group of patients is relevant because of their notoriously high risk for VRE and it allows outcome analysis in a more homogenous cohort than in several other investigations, which included patients with broadly varying underlying diseases [24][25][26][27]. Mortality rates 30 days after VRE-BSI and VSE-BSI ranging from 11.0 to 46.4% and 9 to 38%, respectively, have been reported [24,[28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

“…Recent analyses of enterococcal blood stream infections showed worse outcome when adequate antibiotic treatment was delayed [25,43,44]; Zasowski et al [44] and Vergis et al [11] identified a breakpoint of 48 h after BSI onset. Several studies that supposed a worse outcome associated with VRE compared to VSE bacteraemia [27,28,30] adjusted for neither adequacy nor timeliness of antibiotic therapy. Therefore, this aspect was specifically addressed in the multivariate analysis in the present work.…”

Section: Discussionmentioning

confidence: 99%

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Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study

Dubler

Lenz

Zimmermann

et al. 2020

Antimicrob Resist Infect Control

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Background: The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OLT). Methods: The outcome of OLT recipients developing BSI with vancomycin-resistant (VRE) versus vancomycinsusceptible Enterococcus faecium (VSE) was compared based on data extraction from medical records. Multivariate regression analyses identified risk factors for mortality and unfavourable outcomes (defined as death or prolonged intensive care stay) after 30 and 90 days. Results: Mortality was similar between VRE-(n = 39) and VSE-(n = 138) group after 30 (p = 0.44) or 90 days (p = 0.39). Comparable results occurred regarding unfavourable outcomes. Mean SOFA Non-GCS score during the 7-dayperiod before BSI onset was the independent predictor for mortality at both timepoints (HR 1.32; CI 1.14-1.53; and HR 1.18; CI 1.08-1.28). Timely appropriate antibiotic therapy, recent ICU stay and vancomycin resistance did not affect outcome after adjusting for confounders. Conclusion: Vancomycin resistance did not influence outcome among patients with Enterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population. Trial registration: This study was registered at the German clinical trials register (DRKS-ID: DRKS00013285).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study

Dubler

Lenz

Zimmermann

et al. 2020

Antimicrob Resist Infect Control

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“…Enterococci are the most important cause of nosocomial infections, the third main cause of bacteremia and the most frequent cause of infection at surgical intensive care (ICU) units and are the second most common cause of urinary tract infections (UTI) in hospitals. Enterococci, as a cause of central nervous system (CNS) infection, are extremely rare (5)(6)(7). Enterococcus faecalis is amongst the most frequent pathogens found in urinary tract infections (UTIs), which demonstrates that it can incorporate into mature biofilms (8).…”

Section: Introductionmentioning

confidence: 99%

“…In the recent years, enterococci have been increasingly recognized as important human bacteria causing infections associated with medical devices. Their resistance to most antibacterial agents and their ability to form biofilm has contributed to the increasing incidence of nosocomial enterococcal infections (6).…”

Section: Introductionmentioning

confidence: 99%

Vaginal Colonization and Susceptibility to Antibiotics of Enterococci During Late Pregnancy in Kerman City, Iran

Ghasemi

Mansouri

Shahabi-Nejad³

2016

Arch Clin Infect Dis

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Background: Enterococci are a natural part of the genito-intestinal and gastrointestinal normal flora in humans and are widely distributed in the environment and are one of the most important causes of nosocomial infections. Objectives: The aim of this study was to identify Enterococcus spp. from vaginal samples of pregnant women and measure their antibiotic resistance patterns. Methods: This descriptive study was performed on 602 strains. Vaginal swabs were cultured for Enterococcus spp. from pregnant women at 35 -37 weeks of pregnancy in Kerman city, Iran, during April 2013 to March 2014 or in labor samples transported to the laboratory using Amies transport medium. Swabs were cultivated in Todd Hewitt broth medium and subsequently plated on blood agar plates containing gentamicin and nalidixic acid. Antimicrobial susceptibility testing was performed for enterococci by disk diffusion and minimum inhibitory concentrations (MIC). Results: Vaginal colonization of Enterococcus genus was 8.14%. Parameters of age, parity, history of abortion, history of ruptured membranes, vaginal discharge and other vaginal signs (itching and so on) had no influence on vaginal colonization of Enterococcus spp. The predominant species were respectively E. faecalis 89.8%, E. faecium 6.1% and other Enterococcus spp. 4.1%. All samples were sus-

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“…The identifi cation of risk factors for vancomycin nephrotoxicity will help avoid serious complications (20). Ingram and co-workers evaluated 167 patients receiving vancomycin infusions (112 continuously and 55 intermittently) and concluded that the developmet of nephrotoxicity is slower in the subjects who continuously receive vancomycin infusions.…”

Section: Discussionmentioning

confidence: 99%

The alpha-2 receptor agonist dexmedetomidine attenuates vancomycin‑induced acute kidney injury

Bayram¹,

Erkan²,

Talih³

et al. 2019

BLL

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OBJECTIVE: This study was conducted to evaluate the protective effect of dexmedetomidine on nephrotoxicity and the mechanism of renoprotection following vancomycin-induced nephrotoxicity in rats. METHODS: Thirty-two albino Wistar rats were divided into four groups. The control group received intraperitoneal (IP) physiological saline solution, the vancomycin (VMC) group received IP 200 mg/kg vancomycin, the dexmedetomidine (DEX) group received IP 5 μg/kg dexmedetomidine, and the vancomycin and dexmedetomidine (VMC+DEX) group received IP 200 mg/kg vancomycin followed by IP 5 μg/kg dexmedetomidine 20 min after the vancomycin injection. On the 8th day of the experiment, histopathological and biochemical parameters were assessed. RESULTS: Creatinine levels were signifi cantly higher in VMC and VMC+DEX groups. The endothelin-1 level was signifi cantly higher in VMC group. Nitric oxide levels were statistically lower in VMC and VMC+DEX groups. Histopathologic assessments revealed that the extent of renal damage was signifi cantly higher in group VMC (n = 4 with damage of Grade 3) compared to group VMC+DEX (n = 0 with damage of Grade 3). CONCLUSION: It was determined that dexmedetomidine can reduce the extent of renal damage by preventing the elevation of vasoconstrictor agents (Tab. 2, Fig. 1, Ref. 36).

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Identification of temporal clusters and risk factors of bacteremia by nosocomial vancomycin-resistant enterococci

Cited by 21 publications

References 14 publications

Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study

Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study

Vaginal Colonization and Susceptibility to Antibiotics of Enterococci During Late Pregnancy in Kerman City, Iran

The alpha-2 receptor agonist dexmedetomidine attenuates vancomycin‑induced acute kidney injury

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