Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study
Abstract Background The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OL...
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doaj-a763dd2dccc2424db9d962d300ea0dfd2021-01-31T12:08:24ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-01-019111010.1186/s13756-020-0683-3Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective studyS. Dubler0M. Lenz1S. Zimmermann2D. C. Richter3K. H. Weiss4A. Mehrabi5M. Mieth6T. Bruckner7M. A. Weigand8T. Brenner9A. Heininger10Department of Anaesthesiology, Heidelberg University HospitalDepartment of Anaesthesiology, Heidelberg University HospitalDepartment of Infectious Diseases, Medical Microbiology and Hygiene, Division Bacteriology, Heidelberg University HospitalDepartment of Anaesthesiology, Heidelberg University HospitalDepartment of Internal Medicine, Heidelberg University HospitalDepartment of Visceral and Transplant Surgery, Heidelberg University HospitalDepartment of Visceral and Transplant Surgery, Heidelberg University HospitalInstitute for Medical Biometry and Informatics, University of HeidelbergDepartment of Anaesthesiology, Heidelberg University HospitalDepartment of Anaesthesiology, Heidelberg University HospitalDivision Hospital and Environmental Hygiene Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University HospitalAbstract Background The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OLT). Methods The outcome of OLT recipients developing BSI with vancomycin-resistant (VRE) versus vancomycin-susceptible Enterococcus faecium (VSE) was compared based on data extraction from medical records. Multivariate regression analyses identified risk factors for mortality and unfavourable outcomes (defined as death or prolonged intensive care stay) after 30 and 90 days. Results Mortality was similar between VRE- (n = 39) and VSE- (n = 138) group after 30 (p = 0.44) or 90 days (p = 0.39). Comparable results occurred regarding unfavourable outcomes. Mean SOFANon-GCS score during the 7-day-period before BSI onset was the independent predictor for mortality at both timepoints (HR 1.32; CI 1.14–1.53; and HR 1.18; CI 1.08–1.28). Timely appropriate antibiotic therapy, recent ICU stay and vancomycin resistance did not affect outcome after adjusting for confounders. Conclusion Vancomycin resistance did not influence outcome among patients with Enterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population. Trial registration This study was registered at the German clinical trials register (DRKS-ID: DRKS00013285).https://doi.org/10.1186/s13756-020-0683-3EnterococciBacteraemiaMortalityVancomycin resistanceLiver transplantation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
S. Dubler M. Lenz S. Zimmermann D. C. Richter K. H. Weiss A. Mehrabi M. Mieth T. Bruckner M. A. Weigand T. Brenner A. Heininger |
spellingShingle |
S. Dubler M. Lenz S. Zimmermann D. C. Richter K. H. Weiss A. Mehrabi M. Mieth T. Bruckner M. A. Weigand T. Brenner A. Heininger Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study Antimicrobial Resistance and Infection Control Enterococci Bacteraemia Mortality Vancomycin resistance Liver transplantation |
author_facet |
S. Dubler M. Lenz S. Zimmermann D. C. Richter K. H. Weiss A. Mehrabi M. Mieth T. Bruckner M. A. Weigand T. Brenner A. Heininger |
author_sort |
S. Dubler |
title |
Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study |
title_short |
Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study |
title_full |
Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study |
title_fullStr |
Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study |
title_full_unstemmed |
Does vancomycin resistance increase mortality in Enterococcus faecium bacteraemia after orthotopic liver transplantation? A retrospective study |
title_sort |
does vancomycin resistance increase mortality in enterococcus faecium bacteraemia after orthotopic liver transplantation? a retrospective study |
publisher |
BMC |
series |
Antimicrobial Resistance and Infection Control |
issn |
2047-2994 |
publishDate |
2020-01-01 |
description |
Abstract Background The relevance of vancomycin resistance in enterococcal blood stream infections (BSI) is still controversial. Aim of this study was to outline the effect of vancomycin resistance of Enterococcus faecium on the outcome of patients with BSI after orthotopic liver transplantation (OLT). Methods The outcome of OLT recipients developing BSI with vancomycin-resistant (VRE) versus vancomycin-susceptible Enterococcus faecium (VSE) was compared based on data extraction from medical records. Multivariate regression analyses identified risk factors for mortality and unfavourable outcomes (defined as death or prolonged intensive care stay) after 30 and 90 days. Results Mortality was similar between VRE- (n = 39) and VSE- (n = 138) group after 30 (p = 0.44) or 90 days (p = 0.39). Comparable results occurred regarding unfavourable outcomes. Mean SOFANon-GCS score during the 7-day-period before BSI onset was the independent predictor for mortality at both timepoints (HR 1.32; CI 1.14–1.53; and HR 1.18; CI 1.08–1.28). Timely appropriate antibiotic therapy, recent ICU stay and vancomycin resistance did not affect outcome after adjusting for confounders. Conclusion Vancomycin resistance did not influence outcome among patients with Enterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population. Trial registration This study was registered at the German clinical trials register (DRKS-ID: DRKS00013285). |
topic |
Enterococci Bacteraemia Mortality Vancomycin resistance Liver transplantation |
url |
https://doi.org/10.1186/s13756-020-0683-3 |
work_keys_str_mv |
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