Comparison of morbidity and mortality after bloodstream infection with vancomycin-resistant versus -susceptible Enterococcus faecium: a nationwide cohort study in Denmark, 2010–2019

Autor: Peter Bager, Jonas Kähler, Mikael Andersson, Barbara Juliane Holzknecht, Sanne Grønvall Kjær Hansen, Kristian Schønning, Karen Leth Nielsen, Kristoffer Koch, Mette Pinholt, Marianne Voldstedlund, Anders Rhod Larsen, Brian Kristensen, Kåre Mølbak, Ute Wolff Sönksen, Sissel Skovgaard, Robert Skov, Anette M. Hammerum
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Emerging Microbes and Infections, Vol 13, Iss 1 (2024)
Druh dokumentu: article
ISSN: 22221751
2222-1751
DOI: 10.1080/22221751.2024.2309969
Popis: ABSTRACTThe emergence of bloodstream infections (BSI) caused by vancomycin-resistant Enterococci (VRE) has caused concern. Nonetheless, it remains unclear whether these types are associated with an excess risk of severe outcomes when compared with infections caused by vancomycin-susceptible Enterococci (VSE). This cohort study included hospitalized patients in Denmark with Enterococcus faecium-positive blood cultures collected between 2010 and 2019 identified in the Danish Microbiology Database. We estimated 30-day hazard ratio (HR) of death or discharge among VRE compared to VSE patients adjusted for age, sex, and comorbidity. The cohort included 6071 patients with E. faecium BSI (335 VRE, 5736 VSE) among whom VRE increased (2010–13, 2.6%; 2014–16, 6.3%; 2017–19; 9.4%). Mortality (HR 1.08, 95%CI 0.90–1.29; 126 VRE, 37.6%; 2223 VSE, 37.0%) or discharge (HR 0.89, 95%CI 0.75–1.06; 126 VRE, 37.6%; 2386 VSE, 41.6%) was not different between VRE and VSE except in 2014 (HR 1.87, 95% CI 1.18–2.96). There was no interaction between time from admission to BSI (1–2, 3–14, and >14 days) and HR of death (P = 0.14) or discharge (P = 0.45) after VRE compared to VSE, despite longer time for VRE patients (17 vs. 10 days for VSE, P
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