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

The 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...

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Published in:Emerging microbes & infections 2024-12, Vol.13 (1), p.2309969-2309969
Main Authors: Bager, Peter, Kähler, Jonas, Andersson, Mikael, Holzknecht, Barbara Juliane, Kjær Hansen, Sanne Grønvall, Schønning, Kristian, Nielsen, Karen Leth, Koch, Kristoffer, Pinholt, Mette, Voldstedlund, Marianne, Larsen, Anders Rhod, Kristensen, Brian, Mølbak, Kåre, Sönksen, Ute Wolff, Skovgaard, Sissel, Skov, Robert, Hammerum, Anette M
Format: Article
Language:English
Subjects:
Antibiotics
antimicrobial resistance
Cohort analysis
Enterococci
morbidity
Mortality
nosocomial
vancomycin
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Summary:The 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 -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 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 (  = 0.14) or discharge (  = 0.45) after VRE compared to VSE, despite longer time for VRE patients (17 vs. 10 days for VSE,  
ISSN:2222-1751
2222-1751
DOI:10.1080/22221751.2024.2309969