Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Time Is of the Essence: The Impact of Delayed Antibiotic Therapy on Patient Outcomes in Hospital-Onset Enterococcal Bloodstream Infections.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 1 of them a synthesis that pooled it.
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Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it, 138 citations in OpenAlex.
- Impact of molecular rapid diagnostic testing on clinical outcomes in bloodstream infections: a meta-analysis.BMC infectious diseases · 2026Pooled it
- Optimal vancomycin AUCEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Rapid Molecular Diagnostics for Bloodstream Infection in Patients with Chronic Kidney Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Vancomycin resistance predicts increased mortality in patients with Enterococcus faecium bloodstream infections: a six-year experience at a large tertiary care Italian hospital.The Journal of antimicrobial chemotherapy · 2026Article
- Impact of Rapid Molecular Diagnostic Testing on Outcomes of Patients With Vancomycin-Resistant Enterococcal Bacteremia.Open forum infectious diseases · 2026Article
- Cost-Effectiveness of Automated Blood Culture Systems: Comparison of BACT/ALERT VIRTUO and BD BACTEC FX from a Provider Perspective.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Impact of hemo-alert program on appropriate antimicrobial therapy in hospitalized patients with bacteremia: a quasi-experimental study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Clinical impact and risk factors of enterococcal bacteremia in children: a focus on vancomycin resistance and mortality.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Simultaneous and Accurate Visual Detection of Vancomycin-Resistant EnterococciJournal of microbiology and biotechnology · 2025Article
- Predictors of mortality of enterococcal bacteraemia and the role of source control interventions; a retrospective cohort study.Infection · 2025Article
- Impact of vancomycin resistance on attributable mortality among Enterococcus faecium bloodstream infections: propensity score analysis of a large, multicentre retrospective study.The Journal of antimicrobial chemotherapy · 2025Article
- Intracellular doppler spectroscopy of live tissue sentinels for a fast in-vitro bacterial infection assay.Scientific reports · 2025Article
- REL/DPA/AVI method: a novel approach for rapid detection of carbapenemase-producing Enterobacterales directly from positive blood cultures based on optical density.Journal of clinical microbiology · 2025Article
- Is Enterococcal Bacteremia a Cause or Corollary of Severe Illness? 5 Years' Experience from an Indian Teaching Hospital.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Impact of rapid identification by MALDI-TOF MS from positive blood cultures in Enterococcus spp. bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Clinical Outcomes of Early Phenotype-Desirable Antimicrobial Therapy for Enterobacterales Bacteremia.JAMA network open · 2024Article
- Development of two multiplex PCR assays for rapid detection of eleven Gram-negative bacteria in children with septicemia.Tropical medicine and health · 2024Article
- The Impact ofPathogens (Basel, Switzerland) · 2024Review
- Comparison of Risk Stratification Approaches to Identify Patients with Clostridioides difficile Infection at Risk for Multidrug-Resistant Organism Gut Microbiota Colonization.Infectious diseases and therapy · 2023Article
- Treatment decisions in VRE bacteraemia: a survey of infectious diseases pharmacists.JAC-antimicrobial resistance · 2023Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundWith increasing prevalence of vancomycin-resistant enterococci (VRE), appropriate antibiotic therapy for enterococcal bloodstream infections (EBSI) can be delayed. Data regarding the impact of delayed therapy on EBSI outcomes are conflicting, and the time delay most strongly associated with poor outcomes has not been defined.
methodsThis was a single-center, retrospective cohort study of adult, nonneutropenic patients with hospital-onset EBSI from 2010 to 2014. Classification and regression tree (CART) analysis was used to determine the delay in appropriate therapy most predictive of 30-day mortality. Appropriate therapy was defined as antibiotic therapy to which the enterococci and copathogen, where applicable, were susceptible. Outcomes and clinical characteristics were compared between patients receiving early or delayed therapy, defined by CART timepoint. Poisson regression was employed to determine the independent association of delayed therapy on 30-day mortality and predictors of delayed therapy.
resultsOverall, 190 patients were included. A breakpoint in time to appropriate therapy was identified at 48.1 hours, where 30-day mortality was substantially increased (14.6% vs 45.3%; P < .001). Patients receiving appropriate therapy after 48.1 hours also experienced higher in-hospital mortality and longer EBSI duration. After adjustment for severity of illness and comorbidity, delayed therapy ≥48.1 hours was associated with a 3-fold increase in 30-day mortality (risk ratio, 3.16 [95% confidence interval, 1.96-5.09]). Vancomycin resistance was the only independent predictor of delayed therapy.
conclusionsIn patients with hospital-onset EBSI, receipt of appropriate therapy within the first 48 hours was associated with reduced mortality, underscoring the potential role of rapid diagnostic testing for early identification of VRE.
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