Infection Control and Hospital Epidemiology Publication Info
For individual subscriptions, please contact the The University of Chicago Press
University of Chicago Press Customer Service:
1.877.705.1878 (toll-free, U.S. & Canada)
1.773.753.3347 (international)
subscriptions@press.uchicago.edu
For information about institutional access to this title, please visit the Institutional Subscriptions page.
Enterococcal Bacteremia: Risk Factors for Vancomycin Resistance and Predictors of Mortality
Formats Available in JSTOR: PDF
Abstract(back to top)
OBJECTIVE. To identify risk factors for vancomycin resistance and mortality in enterococcal bacteremia.
DESIGN. Historical cohort study.
SETTING. A large academic medical center with a high prevalence of vancomycin‐resistant enterococci (VRE).
PATIENTS. Two hundred sixty patients with enterococcal bacteremia, of whom 72 (28%) had VRE.
RESULTS. Independent risk factors for infection with VRE were the mean number of antibiotic days (P<.001), renal insufficiency (P<.001), mean days of vancomycin use (P=.005), and neutropenia (P=.013). A trend toward a significant association between metronidazole use and VRE also was noted (P=.068). Mortality was attributable to the bacteremia in 96 patients (37%). Severity of illness (P<.001) and age (P=.020) were independent risk factors for mortality. Vancomycin resistance was not, however, an independent predictor of mortality.
CONCLUSION. These results suggest that restrictions on antibiotic use, particularly in patients with renal insufficiency and neutropenia, may help to combat the rising incidence of VRE. Although patients with VRE bacteremia demonstrated higher mortality rates than patients with infection due to susceptible isolates, vancomycin resistance was not an independent predictor of mortality in these patients and likely serves more as a marker of underlying severity of illness.
Bibliographic Information(back to top)
- Enterococcal Bacteremia: Risk Factors for Vancomycin Resistance and Predictors of Mortality
- Ebbing Lautenbach , MD, MPH, Warren B. Bilker , PhD and Patrick J. Brennan , MD
- Infection Control and Hospital Epidemiology
- Vol. 20, No. 5 (May 1999) (pp. 318-323)
Notes and References(back to top)
This item contains 1 note(s).
Notes
From the Infectious Diseases Division, Department of Internal Medicine (Drs. Lautenbach and Brennan), and the Department of Biostatistics and Epidemiology (Dr. Bilker), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.The authors thank Harvey M. Friedman, MD, and Paul H. Edelstein, MD, for their assistance in reviewing the manuscript.This work was presented in part at the Seventh Annual Meeting of the Society for Healthcare Epidemiology of America, St Louis, Missouri, April 27‐29, 1997.Address reprint requests to Patrick J. Brennan, MD, Infectious Diseases Division, 9 Gates Bldg, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104.97‐OA‐157. Lautenbach E, Bilker WB, Brennan PJ. Enterococcal bacteremia: risk factors for vancomycin resistance and predictors of mortality. Infect Control Hosp Epidemiol 1999;20:318‐323.
Items Citing this Item (back to top)
15 item(s) in JSTOR cite this item
- Eric J. Haas , MD, MSCE; Theoklis E. Zaoutis , MD, MSCE; Priya Prasad , MPH; Mingyao Li , PhD; Susan E. Coffin , MD, MPHVol. 31, No. 10 (October 2010) pp. 1038-1042Stable URL: http://www.jstor.org/stable/10.1086/655464
- Chamion N. Olivier , MD, MSc; Ruth K. Blake , MT; Lisa L. Steed , PhD; Cassandra D. Salgado , MD, MSVol. 29, No. 5 (May 2008) pp. 404-409Stable URL: http://www.jstor.org/stable/10.1086/587647
- Bernard C. Camins , MD, MSCR; Monica M. Farley , MD; John J. Jernigan , MD; Susan M. Ray , MD; James P. Steinberg , MD; Henry M. Blumberg , MDVol. 28, No. 8 (August 2007) pp. 983-991Stable URL: http://www.jstor.org/stable/10.1086/518971
- Carolyn V. Gould , MD, MSc; Richard Rothenberg , MD, MPH; James P. Steinberg , MDVol. 27, No. 9 (September 2006) pp. 920-925Stable URL: http://www.jstor.org/stable/10.1086/507280
- Carlos A. DiazGranados, John A. JerniganVol. 42, No. 8 (Apr. 15, 2006) pp. 1204-1205Stable URL: http://www.jstor.org/stable/4463812
- Esteban C. NanniniVol. 42, No. 8 (Apr. 15, 2006) pp. 1203-1204Stable URL: http://www.jstor.org/stable/4463811
- Shelly A. McNeil, Preeti N. Malani, Carol E. Chenoweth, Robert J. Fontana, John C. Magee, Jeffrey D. Punch, Monica L. Mackin, Carol A. KauffmanVol. 42, No. 2 (Jan. 15, 2006) pp. 195-203Stable URL: http://www.jstor.org/stable/4484556
- Ray Hachem , MD; Linda Graviss , MT(ASCP), CIC; Hend Hanna , MD; Rebecca Arbuckle , MS; Tanya Dvorak , BS; Brenda Hackett , MPH, CIC; Virginia Gonzalez , BS, CIC; Cheryl Perego , MPH, CIC; Jeffrey Tarrand , MD; Issam Raad , MDVol. 25, No. 5 (May 2004) pp. 391-394Stable URL: http://www.jstor.org/stable/10.1086/502411
- Cassandra D. Salgado , MD, MS; Eve T. Giannetta , RN; Barry M. Farr , MD, MScVol. 25, No. 5 (May 2004) pp. 413-417Stable URL: http://www.jstor.org/stable/10.1086/502415
- Carolyn V. Gould , MD; Neil O. Fishman , MD; Irving Nachamkin , DrPH; Ebbing Lautenbach , MD, MPHVol. 25, No. 2 (February 2004) pp. 138-145Stable URL: http://www.jstor.org/stable/10.1086/502365
- Cassandra D. Salgado , MD; Barry M. Farr , MD, MScVol. 24, No. 9 (September 2003) pp. 690-698Stable URL: http://www.jstor.org/stable/10.1086/502271
- Carlene A. Muto , MD, MS; John A. Jernigan , MD, MS; Belinda E. Ostrowsky , MD, MPH; Hervé M. Richet , MD; William R. Jarvis , MD; John M. Boyce , MD; Barry M. Farr , MD, MScVol. 24, No. 5 (May 2003) pp. 362-386Stable URL: http://www.jstor.org/stable/10.1086/502213
- Xiaoyan Song , MD, MS; Arjun Srinivasan , MD; David Plaut , MS; Trish M. Perl , MD, MScVol. 24, No. 4 (April 2003) pp. 251-256Stable URL: http://www.jstor.org/stable/10.1086/502196
- Carlene A. Muto , MD, MS; Eve T. Giannetta , RN; Lisa J. Durbin , BS, MT (ASAP); Barbara M. Simonton , CLT (HEW) ; Barry M. Farr , MD, MScVol. 23, No. 8 (August 2002) pp. 429-435Stable URL: http://www.jstor.org/stable/10.1086/502080
- Philip W. Smith , MDVol. 20, No. 5 (May 1999) pp. 303-305Stable URL: http://www.jstor.org/stable/10.1086/501621