Vancomycin-resistant enterococci bacteremia: Risk factors for mortality and influence of antimicrobial therapy on clinical outcome

Sang Hoon Han, Bum Sik Chin, Han Sung Lee, Su Jin Jeong, Hee Kyoung Choi, Chang Oh Kim, Dongeun Yong, Jun Yong Choi, Young Goo Song, Kyungwon Lee, June Myung Kim

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35 Citations (Scopus)

Abstract

Objectives: This study evaluated the effects of antimicrobial treatment against vancomycin-resistant enterococci (VRE) and delayed administration of anti-VRE therapy on mortality, and determined independent risk factors for delayed all-cause mortality of VRE bacteremia patients. Methods: Over 10 years, 153 patients with clinically significant monomicrobial VRE bacteremia were identified among a total of 2834 patients in a VRE cohort. The main outcomes were immediate (7-day) and delayed (28-day, 60-day) all-cause mortality. Results: The 7-day (P < 0.001) and 28-day (P = 0.041) mortalities were lower in the group receiving anti-VRE therapy, but the 60-day mortality (P = 0.113) was unaffected. The mortalities of patients receiving anti-VRE therapy later than 72 h after the onset of bacteremia were no different from that of patients receiving treatment within 72 h. Both a higher APACHE II score (hazard ratio [HR], 1.10; P < 0.001 and HR, 1.12; P < 0.001, respectively) and the presence of septic shock at the onset of bacteremia (HR, 1.91; P = 0.047 and HR, 1.78; P = 0.034, respectively) were independent risk factors for 28-day and 60-day mortality. Conclusion: These findings suggest that in spite of antibiotic therapy against VRE, patients with VRE bacteremia eventually have a higher risk of death because of severe illness at the onset of bacteremia.

Original languageEnglish
Pages (from-to)182-190
Number of pages9
JournalJournal of Infection
Volume58
Issue number3
DOIs
Publication statusPublished - 2009 Mar

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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