Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study.

Adult Anti-Bacterial Agents / pharmacology Bacteremia / etiology Enterococcus faecium / drug effects Female Humans Liver Transplantation / adverse effects Male Middle Aged Retrospective Studies Treatment Outcome Vancomycin / pharmacology Vancomycin Resistance
Bacteraemia Enterococci Liver transplantation Mortality Vancomycin resistance

Journal

Antimicrobial resistance and infection control
ISSN: 2047-2994
Titre abrégé: Antimicrob Resist Infect Control
Pays: England
ID NLM: 101585411

Informations de publication

Date de publication:
31 01 2020
Historique:
received: 25 11 2019
accepted: 22 01 2020
entrez: 2 2 2020
pubmed: 2 2 2020
medline: 30 12 2020
Statut: epublish

Résumé

The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OLT). The outcome of OLT recipients developing BSI with vancomycin-resistant (VRE) versus vancomycin-susceptible Enterococcus faecium (VSE) was compared based on data extraction from medical records. Multivariate regression analyses identified risk factors for mortality and unfavourable outcomes (defined as death or prolonged intensive care stay) after 30 and 90 days. Mortality was similar between VRE- (n = 39) and VSE- (n = 138) group after 30 (p = 0.44) or 90 days (p = 0.39). Comparable results occurred regarding unfavourable outcomes. Mean SOFA Vancomycin resistance did not influence outcome among patients with Enterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population. This study was registered at the German clinical trials register (DRKS-ID: DRKS00013285).

Sections du résumé

BACKGROUND
The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OLT).
METHODS
The outcome of OLT recipients developing BSI with vancomycin-resistant (VRE) versus vancomycin-susceptible Enterococcus faecium (VSE) was compared based on data extraction from medical records. Multivariate regression analyses identified risk factors for mortality and unfavourable outcomes (defined as death or prolonged intensive care stay) after 30 and 90 days.
RESULTS
Mortality was similar between VRE- (n = 39) and VSE- (n = 138) group after 30 (p = 0.44) or 90 days (p = 0.39). Comparable results occurred regarding unfavourable outcomes. Mean SOFA
CONCLUSION
Vancomycin resistance did not influence outcome among patients with Enterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population.
TRIAL REGISTRATION
This study was registered at the German clinical trials register (DRKS-ID: DRKS00013285).

Identifiants

DOI: 10.1186/s13756-020-0683-3 PMID: 32005223 PMC: PMC6995054
pubmed: 32005223
doi: 10.1186/s13756-020-0683-3
pii: 10.1186/s13756-020-0683-3
pmc: PMC6995054
doi:

Substances chimiques

Anti-Bacterial Agents 0
Vancomycin 6Q205EH1VU

Banques de données

DRKS
['DRKS00013285']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

22

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Auteurs

S Dubler (S)

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany. Simon.Dubler@med.uni-heidelberg.de.
ORCID: 0000-0003-0886-595X

M Lenz (M)

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.
Department of Anaesthesiology, Intensive Care and Emergency Medicine, Asklepios Clinics Hamburg, AK Wandsbek, Hamburg, Germany.

S Zimmermann (S)

Department of Infectious Diseases, Medical Microbiology and Hygiene, Division Bacteriology, Heidelberg University Hospital, Heidelberg, Germany.

D C Richter (DC)

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.

K H Weiss (KH)

Department of Internal Medicine, Heidelberg University Hospital, Heidelberg, Germany.

A Mehrabi (A)

Department of Visceral and Transplant Surgery, Heidelberg University Hospital, Heidelberg, Germany.

M Mieth (M)

Department of Visceral and Transplant Surgery, Heidelberg University Hospital, Heidelberg, Germany.

T Bruckner (T)

Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.

M A Weigand (MA)

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.

T Brenner (T)

Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany.

A Heininger (A)

Division Hospital and Environmental Hygiene Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Does vancomycin resistance increase mortality...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Does vancomycin resistance increase mortality...
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questionsmedicales.fr › Bactéries › Bactéries à Gram positif › Lactobacillales › Enterococcaceae › Enterococcus › Enterococcus faecium › Does vancomycin resistance increase mortality...
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