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Prospective Observational Study of the Clinical Prognoses of Patients with Bloodstream Infections Caused by Ampicillin-Susceptible but Penicillin-Resistant Enterococcus faecalis

Authors
 Dokyun Kim  ;  Hyukmin Lee  ;  Eun-Jeong Yoon  ;  Jun Sung Hong  ;  Jong Hee Shin  ;  Young Uh  ;  Kyeong Seob Shin  ;  Jeong Hwan Shin  ;  Young Ah Kim  ;  Yoon Soo Park  ;  Seok Hoon Jeong 
Citation
 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Vol.63(7) : e00291-19, 2019 
Journal Title
 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY 
ISSN
 0066-4804 
Issue Date
2019
Keywords
CC28 ; Enterococcus faecalis ; ampicillin ; clinical outcome ; penicillin
Abstract
The purpose of this study was to evaluate the clinical impacts of ampicillin-susceptible but penicillin-resistant (ASPR) phenotypes of Enterococcus faecalis on clinical outcomes in patients with bloodstream infection (BSI). A total of 295 patients with an E. faecalis BSI from six sentinel hospitals during a 2-year period (from May 2016 to April 2018) were enrolled in this study. Putative risk factors, including host-, treatment-, and pathogen-related variables, were assessed to determine the associations with the 30-day mortality rate of patients with an E. faecalis BSI. The proportion of ASPR E. faecalis isolates was 22.7% (67/295). ASPR isolates (adjusted odds ratio, 2.27; 95% confidence interval, 1.01 to 5.02) exhibited a significant association with an increased 30-day mortality rate, and a significant difference in survival was identified in a group of patients treated with ampicillin- and/or piperacillin-based regimens who were stratified according to the penicillin susceptibility of the causative pathogen (P = 0.011 by a log rank test). ASPR E. faecalis BSIs resulted in a >2-fold-higher 30-day mortality rate (26.9%; 18/67) than for the BSIs caused by penicillin-susceptible strains (12.3%; 28/228). The differences in mortality rates of patients stratified by penicillin susceptibility were likely due to the treatment failures of ampicillin and/or piperacillin in patients with an ASPR E. faecalis BSI.
Full Text
https://aac.asm.org/content/63/7/e00291-19.long
DOI
10.1128/AAC.00291-19
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dokyun(김도균) ORCID logo https://orcid.org/0000-0002-0348-5440
Lee, Hyuk Min(이혁민) ORCID logo https://orcid.org/0000-0002-8523-4126
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170467
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