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

Kayoko Hayakawa*, Dror Marchaim, Emily T. Martin, Namita Tiwari, Adnan Yousuf, Bharath Sunkara, Harish Pulluru, Harikrishna Kotra, Asma Hasan, Suchitha Bheemreddy, Puja Sheth, Dae Won Lee, Srinivasa Kamatam, Pradeep Bathina, Priyanka Nanjireddy, Indu K. Chalana, Satyam Patel, Sarwan Kumar, Amit Vahia, Kimberly KuVictoria Yee, Jessie Swan, Jason M. Pogue, Paul R. Lephart, Michael J. Rybak, Keith S. Kaye

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

In published studies, cohorts of patients with bacteremia due to vancomycin-resistant Enterococcus (VRE) have predominantly been infected with Enterococcus faecium. Little is known about the epidemiology and outcomes associated with bacteremia due to VR Enterococcus faecalis. A retrospective study of isolates obtained from January 2008 to October 2010 was conducted at Detroit Medical Center (DMC). Unique patients with blood cultures positive for VRE were reviewed. Outcomes were analyzed using logistic regression. 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 in the study cohort was 61.5 ± 15 years; 162 subjects (53.6%) were male. After controlling for a propensity score, bacteremia due to VR E. faecalis was associated with >2-fold-lower in-hospital mortality than bacteremia due to VR E. faecium. Interestingly, bacteremia due to VR E. faecalis was associated with longer hospital stay after VRE isolation, although total length of stay was similar for groups with VR E. faecalis and VR E. faecium. Bacteremia due to VR E. faecalis was associated with a >2-fold-lower risk for mortality than bacteremia due to VR E. faecium, possibly due to the availability of β-lactam therapeutics for treatment of VR E. faecalis.

Original languageEnglish
Pages (from-to)2452-2458
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume56
Issue number5
DOIs
StatePublished - May 2012
Externally publishedYes

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