Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.

We conducted a prospective study to assess the risk factors, molecular epidemiology and outcome of bloodstream infection (BSI) due to Enterococcus faecium in hospitalized cancer patients. Between 2006 and 2012, a significant increase in vancomycin-susceptible E. faecium BSI was observed among cancer...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Carlota Gudiol, Josefina Ayats, Mariana Camoez, M Ángeles Domínguez, Carolina García-Vidal, Marta Bodro, Carmen Ardanuy, Mora Obed, Montserrat Arnan, Maite Antonio, Jordi Carratalà
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d1f4e32e78384cb3a4efcc0bda0f8677
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d1f4e32e78384cb3a4efcc0bda0f8677
record_format	dspace
spelling	oai:doaj.org-article:d1f4e32e78384cb3a4efcc0bda0f86772021-11-18T08:54:33ZIncrease in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.1932-620310.1371/journal.pone.0074734https://doaj.org/article/d1f4e32e78384cb3a4efcc0bda0f86772013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24069339/?tool=EBIhttps://doaj.org/toc/1932-6203We conducted a prospective study to assess the risk factors, molecular epidemiology and outcome of bloodstream infection (BSI) due to Enterococcus faecium in hospitalized cancer patients. Between 2006 and 2012, a significant increase in vancomycin-susceptible E. faecium BSI was observed among cancer patients. Comparison of 54 episodes of BSI due to E. faecium with 38 episodes of BSI due to E. faecalis showed that previous use of carbapenems was the only independent risk factor for E. faecium acquisition (OR 10.24; 95% CI, 1.35-77.66). All E. faecium isolates were susceptible to glycopeptides, whereas 97% showed high-level resistance to ampicillin and ciprofloxacin. All 30 isolates available for genotyping belonged to the hospital-associated E. faecium lineages 17, 18 and 78. After 2009, most of the isolates belonged to ST117 (lineage 78). Patients with E. faecium BSI were more likely to receive inadequate initial empirical antibiotic therapy than patients with E. faecalis BSI, and time to adequate empirical antibiotic therapy was also longer in the former group. No significant differences were found between the two groups regarding early and overall case-fatality rates. Independent risk factors for overall case-fatality were current corticosteroids (OR 4.18; 95% CI, 1.34-13.01) and intensive care unit admission (OR 9.97; 95% CI, 1.96-50.63). The emergence of E. faecium among cancer patients is a concern since there are limited treatment options and it may presage the emergence of vancomycin-resistant enterococci. A rationale approach that combines infection control with antimicrobial stewardship.Carlota GudiolJosefina AyatsMariana CamoezM Ángeles DomínguezCarolina García-VidalMarta BodroCarmen ArdanuyMora ObedMontserrat ArnanMaite AntonioJordi CarratalàPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e74734 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carlota Gudiol Josefina Ayats Mariana Camoez M Ángeles Domínguez Carolina García-Vidal Marta Bodro Carmen Ardanuy Mora Obed Montserrat Arnan Maite Antonio Jordi Carratalà Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
description	We conducted a prospective study to assess the risk factors, molecular epidemiology and outcome of bloodstream infection (BSI) due to Enterococcus faecium in hospitalized cancer patients. Between 2006 and 2012, a significant increase in vancomycin-susceptible E. faecium BSI was observed among cancer patients. Comparison of 54 episodes of BSI due to E. faecium with 38 episodes of BSI due to E. faecalis showed that previous use of carbapenems was the only independent risk factor for E. faecium acquisition (OR 10.24; 95% CI, 1.35-77.66). All E. faecium isolates were susceptible to glycopeptides, whereas 97% showed high-level resistance to ampicillin and ciprofloxacin. All 30 isolates available for genotyping belonged to the hospital-associated E. faecium lineages 17, 18 and 78. After 2009, most of the isolates belonged to ST117 (lineage 78). Patients with E. faecium BSI were more likely to receive inadequate initial empirical antibiotic therapy than patients with E. faecalis BSI, and time to adequate empirical antibiotic therapy was also longer in the former group. No significant differences were found between the two groups regarding early and overall case-fatality rates. Independent risk factors for overall case-fatality were current corticosteroids (OR 4.18; 95% CI, 1.34-13.01) and intensive care unit admission (OR 9.97; 95% CI, 1.96-50.63). The emergence of E. faecium among cancer patients is a concern since there are limited treatment options and it may presage the emergence of vancomycin-resistant enterococci. A rationale approach that combines infection control with antimicrobial stewardship.
format	article
author	Carlota Gudiol Josefina Ayats Mariana Camoez M Ángeles Domínguez Carolina García-Vidal Marta Bodro Carmen Ardanuy Mora Obed Montserrat Arnan Maite Antonio Jordi Carratalà
author_facet	Carlota Gudiol Josefina Ayats Mariana Camoez M Ángeles Domínguez Carolina García-Vidal Marta Bodro Carmen Ardanuy Mora Obed Montserrat Arnan Maite Antonio Jordi Carratalà
author_sort	Carlota Gudiol
title	Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
title_short	Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
title_full	Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
title_fullStr	Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
title_full_unstemmed	Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
title_sort	increase in bloodstream infection due to vancomycin-susceptible enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/d1f4e32e78384cb3a4efcc0bda0f8677
work_keys_str_mv	AT carlotagudiol increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT josefinaayats increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT marianacamoez increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT mangelesdominguez increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT carolinagarciavidal increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT martabodro increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT carmenardanuy increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT moraobed increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT montserratarnan increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT maiteantonio increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes AT jordicarratala increaseinbloodstreaminfectionduetovancomycinsusceptibleenterococcusfaeciumincancerpatientsriskfactorsmolecularepidemiologyandoutcomes
_version_	1718421168827924480

Increase in bloodstream infection due to vancomycin-susceptible Enterococcus faecium in cancer patients: risk factors, molecular epidemiology and outcomes.

Ejemplares similares