Comparison of the clinical characteristics and outcomes associated with vancomycin-resistant Enterococcus faecalis and vancomycin-resistant E. faecium bacteremia.

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Comparison of the clinical characteristics and outcomes associated with vancomycin-resistant Enterococcus faecalis and vancomycin-resistant E. faecium bacteremia.

Antimicrob Agents Chemother. 2012 Feb 21;

Authors: Hayakawa K, Marchaim D, Martin ET, Tiwari N, Yousuf A, Sunkara B, Pulluru H, Kotra H, Hasan A, Bheemreddy S, Sheth P, Lee D, Kamatam S, Bathina P, Nanjireddy P, Chalana IK, Patel S, Kumar S, Vahia A, Ku K, Yee V, Swan J, Pogue JM, Lephart PR, Rybak MJ, Kaye KS

Abstract
Background: Published patient cohorts with bacteremia due to vancomycin-resistant Enterococcus (VRE) have predominantly consisted of E. faecium. Little is known about the epidemiology and outcomes associated with bacteremia due to VR E. faecalis.Methods: A retrospective study from 01/2008 to 10/2010 was conducted at Detroit Medical Center (DMC). Unique patients with blood cultures due to VRE were reviewed. Outcomes were analyzed using logistic regression.Results: During the study period, 105 cases of bacteremia due to VR E. faecalis and 197 cases of bacteremia due to VR E. faecium were identified. The mean age of the study cohort was 61.5 ±15 years, 162 (53.6%) were male. After controlling for a propensity score, bacteremia due to VR E. faecalis was associated with greater than two-fold lower in-hospital mortality, compared to bacteremia due to VR E. faecium. Interestingly, bacteremia due to VR E. faecalis was associated with longer length of hospital stay (LOS) after VRE isolation, although total LOS was similar for VR E. faecalis and VR E. faecium.Conclusions: Bacteremia due to VR E. faecalis was associated with a greater than two-fold lower risk for mortality compared to bacteremia due to VR E. faecium, possibly due to the availability of ? -lactam therapeutics for treatment of VR E. faecalis.

PMID: 22354290 [PubMed - as supplied by publisher]

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