| Autor: |
Hayakawa, Kayoko, Marchaim, Dror, Palla, Mohan, Gudur, Uma Mahesh, Pulluru, Harish, Bathina, Pradeep, Alshabani, Khaled, Govindavarjhulla, Aditya, Mallad, Ashwini, Abbadi, Deepika Reddy, Chowdary, Deepti, Kakarlapudi, Hari, Guddati, Harish, Das, Manoj, Kannekanti, Naveen, Vemuri, Praveen, Doddamani, Rajiv, Mundra, Venkat Ram Rakesh, Guddeti, Raviteja Reddy, Policherla, Rohan, Bai, Sarika, Lohithaswa, Sharan, Shashidharan, Shiva Prasad, Chidurala, Sowmya, Diviti, Sreelatha, Sukayogula, Krishna, Joseph, Melwin, Pogue, Jason M., Lephart, Paul R., Martin, Emily T., Rybak, Michael J., Kaye, Keith S. |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; September 2012, Vol. 57 Issue: 1 p49-55, 7p |
| Abstrakt: |
ABSTRACTAlthough much is known about vancomycin-resistant (VR) Enterococcus faecium, little is known about the epidemiology of VR Enterococcus faecalis. The predilection of VR E. faecalisto transfer the vancomycin resistance determinant to Staphylococcus aureusis much greater than that of VR E. faecium. The epidemiology of VR E. faecalishas important implications regarding the emergence of vancomycin-resistant S. aureus(VRSA); 8 of 13 reported VRSA cases have been from Michigan. A retrospective case-case-control study was conducted at the Detroit Medical Center, located in southeastern Michigan. Unique patients with VR E. faecalisinfection were matched to patients with strains of vancomycin-susceptible (VS) E. faecalisand to uninfected controls at a 1:1:1 ratio. Five hundred thirty-two VR E. faecaliscases were identified and were matched to 532 VS E. faecaliscases and 532 uninfected controls. The overall mean age of the study cohort (n= 1,596) was 63.0 ± 17.4 years, and 747 (46.8%) individuals were male. Independent predictors for the isolation of VR E. faecalis(but not VS E. faecalis) compared to uninfected controls were an age of ≥65 years, nonhome residence, diabetes mellitus, peripheral vascular disease, exposure to cephalosporins and fluoroquinolones in the prior 3 months, and immunosuppressive status. Invasive procedures and/or surgery, chronic skin ulcers, and indwelling devices were risk factors for both VR E. faecalisand VS E. faecalisisolation. Cephalosporin and fluoroquinolone exposures were unique, independent predictors for isolation of VR E. faecalis. A majority of case patients had VR E. faecalispresent at the time of admission. Control of VR E. faecalis, and ultimately VRSA, will likely require regional efforts focusing on infection prevention and antimicrobial stewardship. |
| Databáze: |
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