Clinical Outcomes and Molecular Epidemiology of Vancomycin-Resistant Enterococcus faecium Bloodstream Infection: The Importance of Appropriate Therapy and ST17 Predominance
Randomized trial evaluates mortality factors in VREfm bloodstream infections, suggesting importance of appropriate therapy.
Key Points
The aim was to evaluate factors influencing 14-day mortality in vancomycin-resistant Enterococcus faecium bloodstream infections.
Randomly selected 150 VREfm blood isolates from a tertiary medical center in Northern Taiwan (2021–2023).
Resistance genes detected by PCR; multilocus sequence typing (MLST) and biofilm assays performed.
Primary outcome was analyzed among patients surviving at least three days post-BSI onset to address immortal-time bias.
In the analysis of 137 patients, no anti-VRE therapy was independently associated with increased mortality (aOR 10.44, 95% CI 1.07-101.86; P = 0.04).
Mortality was also linked to higher Pitt bacteraemia score (aOR 1.27; P = 0.003) and lower platelet count (aOR 0.92; P = 0.003).
Daptomycin and linezolid were associated with reduced mortality compared to no anti-VRE therapy (aOR 0.11, P = 0.05 and aOR 0.05, P = 0.04, respectively).