ArticleInfection and drug resistance2019
Vancomycin-resistant enterococcal infection in a Thai university hospital: clinical characteristics, treatment outcomes, and synergistic effect.
Article in Infection and drug resistance, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Synergistic properties of linezolid against Enterococcus spp. isolates: a systematic review from in vitro studies.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Pooled it
- The Global Prevalence of Daptomycin, Tigecycline, and Linezolid-ResistantFrontiers in medicine · 2021Pooled it
- Article
- High-Risk VREfm Clones and Resistance Determinants in a Thai Hospital.Antibiotics (Basel, Switzerland) · 2025Article
- Enhanced efficacy of sequential administration of fosfomycin and linezolid againstFrontiers in microbiology · 2025Article
- Vancomycin Resistance inMicroorganisms · 2022Review
- Assessing the Emergence of Resistance in vitro and Invivo: Linezolid Combined with Fosfomycin Against Fosfomycin-Sensitive and ResistantInfection and drug resistance · 2022Article
- Optimization of Linezolid Dosing Regimens for Treatment of Vancomycin-Resistant Enterococci Infection.Infection & chemotherapy · 2021Article
- Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients withAntibiotics (Basel, Switzerland) · 2021Article
- Pharmacodynamics of Linezolid Plus Fosfomycin Against Vancomycin-ResistantFrontiers in microbiology · 2021Article
- Optimizing the Dosing Regimens of Tigecycline against Vancomycin-Resistant Enterococci in the Treatment of Intra-abdominal and Skin and Soft Tissue Infections.Infection & chemotherapy · 2020Article
- Mild or Malign: Clinical Characteristics and Outcomes of Clostridium difficile Infection in Thailand.Journal of clinical microbiology · 2020Article
- Fosfomycin as Partner Drug for Systemic Infection Management. A Systematic Review of Its Synergistic Properties from In Vitro and In Vivo Studies.Antibiotics (Basel, Switzerland) · 2020Review
- Optimizing the Dosing Regimens of Daptomycin Based on the Susceptible Dose-Dependent Breakpoint against Vancomycin-Resistant Enterococci Infection.Antibiotics (Basel, Switzerland) · 2019Article
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe incidence of infections with vancomycin-resistant enterococci (VRE) is increasing, with associated high mortality rates and limited therapeutic choices. We investigated the clinical characteristics and treatment outcomes of VRE infection and also determined the in vitro effect of monotherapy and combined antimicrobials against clinical VRE isolates. PATIENTS AND
methodsClinical data and bacterial isolates obtained from patients with VRE infections between January 2014 and April 2018 at Phramongkutklao Hospital were reviewed. The clinical outcomes included in-hospital mortality, 30-day mortality, and microbiological eradication. Clonal relationships were assessed by random amplified polymorphic DNA analysis. In vitro activity of linezolid, tigecycline, fosfomycin, gentamicin, chloramphenicol, and ampicillin were determined by minimum inhibitory concentration (MIC) values. Tests of synergy of fosfomycin- or gentamicin-based combinations by the checkerboard method were reported with the fractional inhibitory concentration index or MIC reduction, respectively.
resultsAmong 26 cases of VRE infection, nosocomial and gastrointestinal infections were the most common. There were various treatment regimens, but linezolid-containing regimens were generally used. In-hospital and 30-day mortality were 73.1% and 57.7%, respectively. Higher mortality was significantly associated with illness severity. The VRE isolates tested were universally susceptible to linezolid and tigecycline. A synergistic or additive effect was observed for fosfomycin combined with linezolid (100%) and with tigecycline (83.3%). Fourfold or greater MIC reduction was observed for linezolid or fosfomycin plus gentamicin at concentrations 1 (58.3%, 62.5%), 2 (83.3%, 62.5%), and 4 μg/mL (91.6%, 62.5%).
conclusionIn-hospital mortality among patients with VRE infection was high. Linezolid remains a treatment of choice. However, combination therapy such as linezolid plus fosfomycin and linezolid plus gentamicin should be considered in cases of serious infection.
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