ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Influence of Minimum Inhibitory Concentration in Clinical Outcomes of Enterococcus faecium Bacteremia Treated With Daptomycin: Is it Time to Change the Breakpoint?
Article 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 46 papers, 1 of them a synthesis that pooled it.
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Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
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- Daptomycin failure in the treatment of Enterococcus faecium bacteremia: microbiological insights and the importance of dual therapy including beta-lactam.Critical care (London, England) · 2026Article
- Emergence of vancomycin-resistantEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
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- Clinical Features and Genomic Epidemiology of Bloodstream Infections due to Enterococcal Species Other ThanOpen forum infectious diseases · 2024Article
- Risk factors and outcome associated with the acquisition of MDR linezolid-resistant Enterococcus faecium: a report from tertiary care centre.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- LiaX is a surrogate marker for cell envelope stress and daptomycin non-susceptibility inAntimicrobial agents and chemotherapy · 2024Article
- Phage-Antibiotic Cocktail Rescues Daptomycin and Phage Susceptibility against Daptomycin-Nonsusceptible Enterococcus faecium in a Simulated Endocardial VegetationMicrobiology spectrum · 2023Article
- Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections.Clinical microbiology reviews · 2023Review
- The Combination of Daptomycin with Fosfomycin is More Effective than Daptomycin Alone in Reducing Mortality of Vancomycin-Resistant Enterococcal Bloodstream Infections: A Retrospective, Comparative Cohort Study.Infectious diseases and therapy · 2023Article
- A High Daptomycin Dose Is Associated with Better Bacterial Clearance in Infections Caused by Vancomycin-Resistant Enterococcus faecium Regardless of Daptomycin Minimum Inhibitory Concentration in a Rat Infective Endocarditis Model.Microbiology spectrum · 2022Article
- Antimicrobial Susceptibility Testing for Enterococci.Journal of clinical microbiology · 2022Review
- Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I).Open forum infectious diseases · 2022Article
- Daptomycin-ResistantOpen forum infectious diseases · 2022Article
- Daptomycin versus Glycopeptides for the Treatment ofAntibiotics (Basel, Switzerland) · 2021Article
- Resistance in Vancomycin-Resistant Enterococci.Infectious disease clinics of North America · 2020Review
- Assessment of TedizolidAntimicrobial agents and chemotherapy · 2020Article
- Time-kill curves of daptomycin and Monte Carlo simulation for the treatment of bacteraemia caused by Enterococcus faecium.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2020Article
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundDaptomycin has become a front-line antibiotic for multidrug-resistant Enterococcus faecium bloodstream infections (BSIs). We previously showed that E. faecium strains with daptomycin minimum inhibitory concentrations (MICs) in the higher end of susceptibility frequently harbor mutations associated with daptomycin resistance. We postulate that patients with E. faecium BSIs exhibiting daptomycin MICs of 3-4 µg/mL treated with daptomycin are more likely to have worse clinical outcomes than those exhibiting daptomycin MICs ≤2 µg/mL.
methodsWe conducted a multicenter retrospective cohort study that included adult patients with E. faecium BSI for whom initial isolates, follow-up blood culture data, and daptomycin administration data were available. A central laboratory performed standardized daptomycin MIC testing for all isolates. The primary outcome was microbiologic failure, defined as clearance of bacteremia ≥4 days after the index blood culture. The secondary outcome was all-cause in-hospital mortality.
resultsA total of 62 patients were included. Thirty-one patients were infected with isolates that exhibited daptomycin MICs of 3-4 µg/mL. Overall, 34 patients had microbiologic failure and 25 died during hospitalization. In a multivariate logistic regression model, daptomycin MICs of 3-4 µg/mL (odds ratio [OR], 4.7 [1.37-16.12]; P = .014) and immunosuppression (OR, 5.32 [1.20-23.54]; P = .028) were significantly associated with microbiologic failure. Initial daptomycin dose of ≥8 mg/kg was not significantly associated with evaluated outcomes.
conclusionsDaptomycin MICs of 3-4 µg/mL in the initial E. faecium blood isolate predicted microbiological failure of daptomycin therapy, suggesting that modification in the daptomycin breakpoint for enterococci should be considered.
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