Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection

Michael B Edmond; Janis F Ober; David L Weinbaum; Michael A Pfaller; Taekyu Hwang; Melissa D Sanford; Richard P Wenzel

doi:10.1093/clinids/20.5.1126

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Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection

Journal article

Peer reviewed

Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection

Michael B Edmond, Janis F Ober, David L Weinbaum, Michael A Pfaller, Taekyu Hwang, Melissa D Sanford and Richard P Wenzel

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.20(5), pp.1126-1133

05/1995

DOI: 10.1093/clinids/20.5.1126

PMID: 7619987

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Abstract

We describe an outbreak of vancomycin-resistant Enterococcus faecium (vanA phenotype) bacteremia on the oncology ward of a tertiary care community hospital. In 10 of the 11 cases the patients had leukemia and were neutropenic (median duration of neutropenia, 21 days) at the time of bacteremia. On average, patients received six antibiotic agents for a total of 61 agent-days prior to development of vancomycin-resistant E. faecium bacteremia. The mortality rate was 73%. Molecular typing of 22 isolates revealed that the majority (83%) represented a common strain, indicating nosocomial spread. When the 11 cases were compared to 22 matched control patients, gastrointestinal colonization with vancomycin-resistant E. faecium (odds ratio [denominator, 0] infinity, P = .005) and the use of antimicrobial agents with significant activity against anaerobes (metronidazole, clindamycin, and imipenem; odds ratio infinity, P = .02) were found to be risk factors for the development of vancomycin-resistant E. faecium bacteremia. Since no proven therapy for such infection exists, there is an urgent need to identify effective measures to prevent and control the development of vancomycin-resistant E. faecium bacteremia.

Enterococcus faecium - drug effects

Cross Infection - etiology

Humans

Middle Aged

Risk Factors

Bacteremia - drug therapy

Male

Gram-Positive Bacterial Infections - etiology

Case-Control Studies

Gram-Positive Bacterial Infections - epidemiology

Drug Resistance, Microbial

Disease Outbreaks

Vancomycin - therapeutic use

Bacteremia - etiology

Adult

Bacteremia - epidemiology

Female

Aged

Gram-Positive Bacterial Infections - drug therapy

Details

Title: Subtitle: Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection
Creators: Michael B Edmond - Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, USA
Janis F Ober
David L Weinbaum
Michael A Pfaller
Taekyu Hwang
Melissa D Sanford
Richard P Wenzel
Resource Type: Journal article
Publication Details: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol.20(5), pp.1126-1133
Publisher: United States
DOI: 10.1093/clinids/20.5.1126
PMID: 7619987
ISSN: 1058-4838
eISSN: 1537-6591
Grant note: T32AIO7374 / NIAID NIH HHS
Language: English
Date published: 05/1995
Academic Unit: Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983905532702771

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