Epidemiology of vancomycin-resistant enterococci with reduced susceptibility to daptomycin

• Published in: Infection control and hospital epidemiology Vol. 33; no. 12; p. 1250
• Main Authors: Judge, Theresa, Pogue, Jason M, Marchaim, Dror, Ho, Kevin, Kamatam, Srinivasa, Parveen, Shakila, Tiwari, Namita, Nanjireddy, Priyanka, Bheemreddy, Suchitha, Biedron, Caitlin, Reddy, Sagar Mallikethi Lepakshi, Khammam, Vijaykumar, Chalana, Indu K, Tumma, Rajachendra Shekher, Collins, Vicki, Yousuf, Adnan, Lephart, Paul R, Martin, Emily T, Rybak, Michael J, Kaye, Keith S, Hayakawa, Kayoko
• Format: Journal Article
• Language: English
• Published: United States 01.12.2012
• Subjects: Adult; Aged; Anti-Bacterial Agents - pharmacology; Case-Control Studies; Cephalosporins - therapeutic use; Comorbidity; Daptomycin - pharmacology; Drug Resistance, Multiple, Bacterial; Enterococcus faecalis - drug effects; Enterococcus faecium - drug effects; Female; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Humans; Immunosuppression; Male; Metronidazole - therapeutic use; Middle Aged; Proportional Hazards Models; Retrospective Studies; Risk Factors; Statistics, Nonparametric; Vancomycin - pharmacology; Vancomycin Resistance
• ISSN: 1559-6834
• DOI: 10.1086/668438

A retrospective case-case control study was conducted, including 60 cases with daptomycin-nonsusceptible vancomycin-resistant enterococci (DNS-VRE) matched to cases with daptomycin-susceptible VRE and to uninfected controls (1∶1∶3 ratio). Immunosuppression, presence of comorbid conditions, and prior exposure to antimicrobials were independent predictors of DNS-VRE, although prior daptomycin exposure occurred rarely. In summary, a case-case control study identified independent risk factors for the isolation of DNS-VRE: immunosuppression, multiple comorbid conditions, and prior exposures to cephalosporines and metronidazole.