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Open AccessArticle

Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

1
Department of Pharmacy Practice and Pharmaceutical Care, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand
2
Pharmaceutical Initiative for Resistant Bacteria and Infectious Disease Working Group [PIRBIG], Nakorn Pathom 73000, Thailand
3
Division of Infectious Disease, Department of Medicine, Phramongkutklao Hospital, Bangkok 10400, Thailand
4
Faculty of Medical Technology, Nakhonratchasima College, Nakhon Ratchasima 30000, Thailand
5
Department of Pharmacy, Faculty of Pharmacy, Silapakorn University, Nakorn Pathom 73000, Thailand
*
Author to whom correspondence should be addressed.
Academic Editor: Jesus Simal-Gandara
Received: 27 December 2020 / Revised: 18 January 2021 / Accepted: 18 January 2021 / Published: 22 January 2021
(This article belongs to the Section The Global Need for Effective Antibiotics)
The prevalence of enterococcal infection, especially E. faecium, 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 E. faecium 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 E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium 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-E. faecium infection. In logistic regression analysis, VR-E. faecium, 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-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), 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-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes. View Full-Text
Keywords: Enterococci; survival; risk factor; VRE; glycopeptide Enterococci; survival; risk factor; VRE; glycopeptide
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MDPI and ACS Style

Hemapanpairoa, J.; Changpradub, D.; Thunyaharn, S.; Santimaleeworagun, W. Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections. Antibiotics 2021, 10, 105. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020105

AMA Style

Hemapanpairoa J, Changpradub D, Thunyaharn S, Santimaleeworagun W. Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections. Antibiotics. 2021; 10(2):105. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020105

Chicago/Turabian Style

Hemapanpairoa, Jatapat; Changpradub, Dhitiwat; Thunyaharn, Sudaluck; Santimaleeworagun, Wichai. 2021. "Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections" Antibiotics 10, no. 2: 105. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020105

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