| Enterococcus faecium bacteremia: does vancomycin resistance make a difference? | |
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MedLine Citation:
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PMID: 9508230 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Enterococcus faecium has received increased attention, primarily due to the emergence of vancomycin resistance. The purpose of this investigation was to study the epidemiological characteristics of vancomycin-resistant E faecium (VRE) bacteremia and to determine the clinical impact of vancomycin resistance on the outcome of patients with this infection. METHODS: We retrospectively analyzed the clinical features and outcome of 53 patients with E faecium bacteremia. RESULTS: From January 1992 until December 1995, there were 32 episodes of bacteremia caused by vancomycin-susceptible E faecium (VSE) and 21 caused by VRE. An intra-abdominal site was the most common source of bacteremia in both groups. All of the VRE and 78% of VSE bacteremia cases were nosocomially acquired. Previous administration of vancomycin was associated with VRE bacteremia (P<.001), as were indwelling bladder catheters (P=.01). Fifty-nine percent of the patients with VSE bacteremia survived vs 24% with VRE (P=.009), despite similar severity-of-illness scores. In 62% of the patients with VRE sepsis, death was related to the bacteremia (P=.01). Patients infected with VRE had longer hospitalizations than those with VSE (34.8 vs 16.7 days, respectively) (P=.004), were more likely to be on the medical service (P=.03), and on the average, had hospitalization costs of more than $27,000 per episode than did patients with VSE bloodstream infection ($83,897 vs $56,707, respectively) (P=.04). CONCLUSIONS: 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. |
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Authors:
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V Stosor; L R Peterson; M Postelnick; G A Noskin |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of internal medicine Volume: 158 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 1998 Mar |
Date Detail:
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Created Date: 1998-03-24 Completed Date: 1998-03-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 522-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Northwestern University Medical School, Chicago, Ill 60611, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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pharmacology* Bacteremia / drug therapy*, etiology, microbiology* Drug Resistance, Microbial Enterococcus faecium* Female Gram-Positive Bacterial Infections / drug therapy*, etiology, microbiology* Humans Male Middle Aged Retrospective Studies Treatment Outcome Vancomycin / pharmacology* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 1404-90-6/Vancomycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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