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Vancomycin-resistant enterococci bacteremia: risk factors for mortality and influence of antimicrobial therapy on clinical outcome

Authors
 Sang Hoon Han  ;  Bum Sik Chin  ;  Han Sung Lee  ;  Su Jin Jeong  ;  Hee Kyoung Choi  ;  Chang Oh Kim  ;  Dongeun Yong  ;  Jun Yong Choi  ;  Young Goo Song  ;  Kyungwon Lee  ;  June Myung Kim 
Citation
 Journal of Infection, Vol.58(3) : 182-190, 2009 
Journal Title
 Journal of Infection 
ISSN
 0163-4453 
Issue Date
2009
Abstract
OBJECTIVES: This study evaluated the effects of antimicrobial treatment against vancomycin-resistant enterococci (VRE) and delayed administration of anti-VRE therapy on mortality, and determined independent risk factors for delayed all-cause mortality of VRE bacteremia patients. METHODS: Over 10 years, 153 patients with clinically significant monomicrobial VRE bacteremia were identified among a total of 2834 patients in a VRE cohort. The main outcomes were immediate (7-day) and delayed (28-day, 60-day) all-cause mortality. RESULTS: The 7-day (P<0.001) and 28-day (P=0.041) mortalities were lower in the group receiving anti-VRE therapy, but the 60-day mortality (P=0.113) was unaffected. The mortalities of patients receiving anti-VRE therapy later than 72h after the onset of bacteremia were no different from that of patients receiving treatment within 72h. Both a higher APACHE II score (hazard ratio [HR], 1.10; P<0.001 and HR, 1.12; P<0.001, respectively) and the presence of septic shock at the onset of bacteremia (HR, 1.91; P=0.047 and HR, 1.78; P=0.034, respectively) were independent risk factors for 28-day and 60-day mortality. CONCLUSION: These findings suggest that in spite of antibiotic therapy against VRE, patients with VRE bacteremia eventually have a higher risk of death because of severe illness at the onset of bacteremia.
Full Text
http://www.sciencedirect.com/science/article/pii/S016344530900036X
DOI
10.1016/j.jinf.2009.01.013
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김준명(Kim, June Myung)
김창오(Kim, Chang Oh) ORCID logo https://orcid.org/0000-0002-0773-5443
송영구(Song, Young Goo) ORCID logo https://orcid.org/0000-0002-0733-4156
용동은(Yong, Dong Eun) ORCID logo https://orcid.org/0000-0002-1225-8477
이경원(Lee, Kyungwon) ORCID logo https://orcid.org/0000-0003-3788-2134
이한성(Lee, Han Sung)
정수진(Jeong, Su Jin) ORCID logo https://orcid.org/0000-0003-4025-4542
진범식(Chin, Bum Sik)
최준용(Choi, Jun Yong) ORCID logo https://orcid.org/0000-0002-2775-3315
최희경(Choi, Hee Kyoung)
한상훈(Han, Sang Hoon) ORCID logo https://orcid.org/0000-0002-4278-5198
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103550
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