Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with <i>Enterococcus faecium</i> Infections
The prevalence of enterococcal infection, especially <i>E. faecium,</i> is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by <i>E. faecium</i> an...
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| Main Authors: | , , , |
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| Format: | Book |
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MDPI AG,
2021-01-01T00:00:00Z.
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| Summary: | The prevalence of enterococcal infection, especially <i>E. faecium,</i> is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by <i>E. faecium</i> and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with <i>E. faecium</i> infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-<i>E. faecium</i> vs. vancomycin susceptible (VS)-<i>E. faecium</i> were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-<i>E. faecium</i> infection. In logistic regression analysis, VR-<i>E. faecium</i>, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-<i>E. faecium</i> infection (HR 1.91; 95%CI 1.09-3.37)<i>,</i> SOFA scores of 6-9 points (HR 2.69; 95%CI 1.15-6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70-8.13), and bone and joint infections (HR 0.08; 95%CI 0.01-0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-<i>E. faecium</i> infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-<i>E. faecium</i> infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes. |
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| Item Description: | 10.3390/antibiotics10020105 2079-6382 |