https://scholars.lib.ntu.edu.tw/handle/123456789/535187
標題: | Microbiological and clinical characteristics of vancomycin-resistant Enterococcus faecium bacteraemia in Taiwan: Implication of sequence type for prognosis | 作者: | Lu C.-L. YU-CHUNG CHUANG Chang H.-C. YEE-CHUN CHEN JANN-TAY WANG SHAN-CHWEN CHANG |
公開日期: | 2012 | 卷: | 67 | 期: | 9 | 起(迄)頁: | 2243-2249 | 來源出版物: | Journal of Antimicrobial Chemotherapy | 摘要: | Objectives: Vancomycin-resistant enterococci (VRE), particularly vancomycin-resistant Enterococcus faecium (VREfm), have emerged among the leading pathogens causing hospital-acquired infections worldwide. We aimed to examine whether there were newly introduced clones contributing to this increase and to assess the risk factors for mortality in patients with VREfm bacteraemia. Methods: Between 2003 and 2010, all medical records of adult patients diagnosed with VREfm bacteraemia at a university hospital in Taiwan were reviewed. Antibiotic susceptibility, genotyping and multilocus sequence typing of the VREfm isolates were performed. Results: During the study period, the prevalence of non-duplicated blood VRE isolates increased significantly from 3.9% in 2003 to 18.9% in 2010 (P < 0.0001). One-hundred-and-forty-nine patients with VREfm bacteraemia were noted and 102 isolates of VREfm were available for microbiological characterization. All isolates were susceptible to daptomycin and linezolid. Sequence type (ST) 18 and ST414 were the two predominant emerging STs from 2009 to 2010, accounting for 29.7% and 25.0% of all isolates, respectively. Patients who received immunosuppressives, had a high Charlson comorbidity index or experienced septic shock had a significantly higher 14 day mortality rate. Patients who had bacteraemia caused by ST414 isolates and received appropriate antibiotics had a lower 14 day mortality rate. Conclusions: The prevalence of the VRE that caused bacteraemia increased from 2003 to 2010. This increase might be attributed to the clonal spread of VREfm belonging to ST18 and ST414. The all-cause 14 day mortality rate was lower in patients with bacteraemia due to VREfm isolates that belonged to ST414. ? The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84865376832&doi=10.1093%2fjac%2fdks181&partnerID=40&md5=77f0901c2033474e8154481400d006c3 https://scholars.lib.ntu.edu.tw/handle/123456789/535187 |
ISSN: | 0305-7453 | DOI: | 10.1093/jac/dks181 | SDG/關鍵字: | ampicillin; antibiotic agent; ciprofloxacin; daptomycin; erythromycin; immunosuppressive agent; linezolid; minocycline; penicillin G; rifampicin; teicoplanin; tigecycline; vancomycin; adult; antibiotic resistance; antibiotic therapy; article; bacteremia; bacterium isolate; comorbidity; enterococcal infection; Enterococcus faecium; female; genotype; human; immunosuppressive treatment; length of stay; major clinical study; male; medical record review; mortality; multilocus sequence typing; nonhuman; prevalence; prognosis; risk assessment; risk factor; sepsis; septic shock; side effect; Taiwan; vancomycin resistant Enterococcus; vancomycin resistant Enterococcus faecium; vancomycin resistant Enterococcus faecium bacteremia; Adult; Bacteremia; Cluster Analysis; Cohort Studies; Cross Infection; Enterococcus faecium; Female; Genotype; Gram-Positive Bacterial Infections; Hospitals, University; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Epidemiology; Molecular Typing; Prognosis; Retrospective Studies; Survival Analysis; Taiwan; Vancomycin Resistance |
顯示於: | 醫學系 |
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