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 language | English |
|---|---|
| Pages (from-to) | 182-190 |
| Number of pages | 9 |
| Journal | Journal of Infection |
| Volume | 58 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2009 Mar 1 |
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All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
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Vancomycin-resistant enterococci bacteremia : Risk factors for mortality and influence of antimicrobial therapy on clinical outcome. / Han, Sang Hoon; Chin, Bum Sik; Lee, Han Sung; Jeong, Su Jin; Choi, Hee Kyoung; Kim, Chang Oh; Yong, Dongeun; Choi, Jun Yong; Song, Young Goo; Lee, Kyungwon; Kim, June Myung.
In: Journal of Infection, Vol. 58, No. 3, 01.03.2009, p. 182-190.Research output: Contribution to journal › Article
TY - JOUR
T1 - Vancomycin-resistant enterococci bacteremia
T2 - Risk factors for mortality and influence of antimicrobial therapy on clinical outcome
AU - Han, Sang Hoon
AU - Chin, Bum Sik
AU - Lee, Han Sung
AU - Jeong, Su Jin
AU - Choi, Hee Kyoung
AU - Kim, Chang Oh
AU - Yong, Dongeun
AU - Choi, Jun Yong
AU - Song, Young Goo
AU - Lee, Kyungwon
AU - Kim, June Myung
PY - 2009/3/1
Y1 - 2009/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=61349182487&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=61349182487&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2009.01.013
DO - 10.1016/j.jinf.2009.01.013
M3 - Article
C2 - 19233476
AN - SCOPUS:61349182487
VL - 58
SP - 182
EP - 190
JO - Journal of Infection
JF - Journal of Infection
SN - 0163-4453
IS - 3
ER -