BACKGROUND AND PURPOSE: Vancomycin-resistant enterococci (VRE) have emerged as important nosocomial pathogens. This study was conducted to clarify the clinical features and outcome of patients with vancomycin-resistant enterococcal bacteremia. METHODS: Patients with vancomycin-resistant enterococcal bacteremia treated at a medical center in northern Taiwan between November 1998 and July 2006 were reviewed. Clinical and bacteriological characteristics of Enterococcus faecium and Enterococcus faecalis were compared. RESULTS: Twelve patients (6 males and 6 females) were included for analyses. The mean age was 69.3 years (range, 40 to 86 years), and 8 cases (66.7%) were older than 65 years. All patients had underlying disease. Two patients received total hip replacement before development of VRE bacteremia. Twelve patients had prior exposure to broad-spectrum antimicrobial therapy. Ten patients had prior intensive care unit stay and prior mechanical ventilation before VRE bacteremia. All of the patients (n = 12) had an intravascular catheter in place. Bacteremia was caused by E. faecalis in 4 patients and by E. faecium in eight. The portals of entry included urinary tract (8.3%), skin, soft tissue and bone (41.7%) and unknown sources (50.0%). E. faecium showed a higher rate of resistance to ampicillin and teicoplanin than E. faecalis (87.5% vs 0.0%, p=0.01). The 60-day mortality rate was higher in patients with E. faecium bacteremia than E. faecalis bacteremia (62.5% vs 0.0%), although statistical significance was not obtained (p=0.08). CONCLUSIONS: VRE bacteremia may have an impact on the mortality and morbidity of hospitalized patients. Patients with bacteremia caused by vancomycin-resistant E. faecium had a grave prognosis, especially immunosuppressed patients. The prudent use of antibiotics and strict enforcement of infection control may prevent further emergence and spread of VRE.
BACKGROUND AND PURPOSE:Vancomycin-resistant enterococci (VRE) have emerged as important nosocomial pathogens. This study was conducted to clarify the clinical features and outcome of patients with vancomycin-resistant enterococcal bacteremia. METHODS:Patients with vancomycin-resistant enterococcal bacteremia treated at a medical center in northern Taiwan between November 1998 and July 2006 were reviewed. Clinical and bacteriological characteristics of Enterococcus faecium and Enterococcus faecalis were compared. RESULTS: Twelve patients (6 males and 6 females) were included for analyses. The mean age was 69.3 years (range, 40 to 86 years), and 8 cases (66.7%) were older than 65 years. All patients had underlying disease. Two patients received total hip replacement before development of VRE bacteremia. Twelve patients had prior exposure to broad-spectrum antimicrobial therapy. Ten patients had prior intensive care unit stay and prior mechanical ventilation before VRE bacteremia. All of the patients (n = 12) had an intravascular catheter in place. Bacteremia was caused by E. faecalis in 4 patients and by E. faecium in eight. The portals of entry included urinary tract (8.3%), skin, soft tissue and bone (41.7%) and unknown sources (50.0%). E. faecium showed a higher rate of resistance to ampicillin and teicoplanin than E. faecalis (87.5% vs 0.0%, p=0.01). The 60-day mortality rate was higher in patients with E. faeciumbacteremia than E. faecalisbacteremia (62.5% vs 0.0%), although statistical significance was not obtained (p=0.08). CONCLUSIONS:VRE bacteremia may have an impact on the mortality and morbidity of hospitalized patients. Patients with bacteremia caused by vancomycin-resistant E. faecium had a grave prognosis, especially immunosuppressed patients. The prudent use of antibiotics and strict enforcement of infection control may prevent further emergence and spread of VRE.
Authors: Massimo Sartelli; Pierluigi Viale; Kaoru Koike; Federico Pea; Fabio Tumietto; Harry van Goor; Gianluca Guercioni; Angelo Nespoli; Cristian Tranà; Fausto Catena; Luca Ansaloni; Ari Leppaniemi; Walter Biffl; Frederick A Moore; Renato Poggetti; Antonio Daniele Pinna; Ernest E Moore Journal: World J Emerg Surg Date: 2011-01-13 Impact factor: 5.469
Authors: Ana M Guzmán Prieto; Rolf T Urbanus; Xinglin Zhang; Damien Bierschenk; C Arnold Koekman; Miranda van Luit-Asbroek; Janneke P Ouwerkerk; Marieke Pape; Fernanda L Paganelli; Dominique Wobser; Johannes Huebner; Antoni P A Hendrickx; Marc J M Bonten; Rob J L Willems; Willem van Schaik Journal: Sci Rep Date: 2015-12-17 Impact factor: 4.379
Authors: Massimo Sartelli; Dieter G Weber; Etienne Ruppé; Matteo Bassetti; Brian J Wright; Luca Ansaloni; Fausto Catena; Federico Coccolini; Fikri M Abu-Zidan; Raul Coimbra; Ernest E Moore; Frederick A Moore; Ronald V Maier; Jan J De Waele; Andrew W Kirkpatrick; Ewen A Griffiths; Christian Eckmann; Adrian J Brink; John E Mazuski; Addison K May; Rob G Sawyer; Dominik Mertz; Philippe Montravers; Anand Kumar; Jason A Roberts; Jean-Louis Vincent; Richard R Watkins; Warren Lowman; Brad Spellberg; Iain J Abbott; Abdulrashid Kayode Adesunkanmi; Sara Al-Dahir; Majdi N Al-Hasan; Ferdinando Agresta; Asma A Althani; Shamshul Ansari; Rashid Ansumana; Goran Augustin; Miklosh Bala; Zsolt J Balogh; Oussama Baraket; Aneel Bhangu; Marcelo A Beltrán; Michael Bernhard; Walter L Biffl; Marja A Boermeester; Stephen M Brecher; Jill R Cherry-Bukowiec; Otmar R Buyne; Miguel A Cainzos; Kelly A Cairns; Adrian Camacho-Ortiz; Sujith J Chandy; Asri Che Jusoh; Alain Chichom-Mefire; Caroline Colijn; Francesco Corcione; Yunfeng Cui; Daniel Curcio; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Sameer Dhingra; José J Diaz; Isidoro Di Carlo; Angel Dillip; Salomone Di Saverio; Michael P Doyle; Gereltuya Dorj; Agron Dogjani; Hervé Dupont; Soumitra R Eachempati; Mushira Abdulaziz Enani; Valery N Egiev; Mutasim M Elmangory; Paula Ferrada; Joseph R Fitchett; Gustavo P Fraga; Nathalie Guessennd; Helen Giamarellou; Wagih Ghnnam; George Gkiokas; Staphanie R Goldberg; Carlos Augusto Gomes; Harumi Gomi; Manuel Guzmán-Blanco; Mainul Haque; Sonja Hansen; Andreas Hecker; Wolfgang R Heizmann; Torsten Herzog; Adrien Montcho Hodonou; Suk-Kyung Hong; Reinhold Kafka-Ritsch; Lewis J Kaplan; Garima Kapoor; Aleksandar Karamarkovic; Martin G Kees; Jakub Kenig; Ronald Kiguba; Peter K Kim; Yoram Kluger; Vladimir Khokha; Kaoru Koike; Kenneth Y Y Kok; Victory Kong; Matthew C Knox; Kenji Inaba; Arda Isik; Katia Iskandar; Rao R Ivatury; Maurizio Labbate; Francesco M Labricciosa; Pierre-François Laterre; Rifat Latifi; Jae Gil Lee; Young Ran Lee; Marc Leone; Ari Leppaniemi; Yousheng Li; Stephen Y Liang; Tonny Loho; Marc Maegele; Sydney Malama; Hany E Marei; Ignacio Martin-Loeches; Sanjay Marwah; Amos Massele; Michael McFarlane; Renato Bessa Melo; Ionut Negoi; David P Nicolau; Carl Erik Nord; Richard Ofori-Asenso; AbdelKarim H Omari; Carlos A Ordonez; Mouaqit Ouadii; Gerson Alves Pereira Júnior; Diego Piazza; Guntars Pupelis; Timothy Miles Rawson; Miran Rems; Sandro Rizoli; Claudio Rocha; Boris Sakakushev; Miguel Sanchez-Garcia; Norio Sato; Helmut A Segovia Lohse; Gabriele Sganga; Boonying Siribumrungwong; Vishal G Shelat; Kjetil Soreide; Rodolfo Soto; Peep Talving; Jonathan V Tilsed; Jean-Francois Timsit; Gabriel Trueba; Ngo Tat Trung; Jan Ulrych; Harry van Goor; Andras Vereczkei; Ravinder S Vohra; Imtiaz Wani; Waldemar Uhl; Yonghong Xiao; Kuo-Ching Yuan; Sanoop K Zachariah; Jean-Ralph Zahar; Tanya L Zakrison; Antonio Corcione; Rita M Melotti; Claudio Viscoli; Perluigi Viale Journal: World J Emerg Surg Date: 2016-07-15 Impact factor: 5.469