ArticleThe Journal of antimicrobial chemotherapy2025
Impact of vancomycin resistance on attributable mortality among Enterococcus faecium bloodstream infections: propensity score analysis of a large, multicentre retrospective study.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Outcomes of linezolid, glycopeptides, and other regimens in ampicillin-resistant, vancomycin-susceptible and vancomycin-resistant enterococcal bacteremia in a resource-limited setting: stewardship implications.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Assessing appropriateness of antibiotic therapy: a scoping review of definitions and their clinical implication.Infection · 2026Article
- Temporal Trends and Mortality of Vancomycin-ResistantPathogens (Basel, Switzerland) · 2026Observational
- 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 Vancomycin Resistance on 30-Day Mortality in Solid Organ Transplant Recipients withAntibiotics (Basel, Switzerland) · 2026Article
- Antimicrobial resistance patterns and risk factors ofFrontiers in public health · 2026Article
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConflicting results exist about mortality risk of infections caused by vancomycin-susceptible Enterococcus faecium (VSEfm) and vancomycin-resistant Enterococcus faecium (VREfm). Our aim was to compare risk factors and clinical outcomes among patients with VSEfm and VREfm bloodstream infections (BSIs).
methodsA retrospective, multicentre, cohort study enrolled consecutive adult patients with VSEfm and VREfm BSI diagnosis between 2018-2022. Primary outcomes were 30-day-attributable and 30-day-overall mortality. Multivariable analysis propensity-weighted adjusted for timing to active therapy, Pitt Bacteremia Score (PBS) and Charlson Comorbidity Index (CCI) were performed to identify variables independently associated with 30-day mortality.
resultsOverall, 446 patients were enrolled: 140 (31.4%) VREfm and 306 (68.6%) VSEfm. Comparatively, VREfm patients more frequently received inappropriate antibiotic therapy, had higher sequential organ failure assessment, PBS and BSI relapses. 30-day-attributable and 30-day-overall mortality did not differ significantly between the two groups. Independent risk factors for 30-day attributable mortality were age (HR 1.04, CI95%, 1.00-1.08, P = 0.022), corticosteroid therapy (HR 3.05, CI95%, 1.24-7.47, P = 0.014) and septic shock (HR 9.10, CI95%, 3.80-21.79, P≤0.001), and overall mortality were age (HR 1.04, CI95%, 1.02-1.05, P≤0.001.), chronic liver failure (HR 1.67, CI95%, 1.02-2.75, P = 0.04) and haematological disease (HR 2.25, CI95%, 1.28-3.94, P = 0.005). Vancomycin resistance is not an independent risk factor for mortality when data are adjusted for confounding factors.
conclusionsAdjusted analyses for time to active antibiotic therapy suggest that vancomycin resistance is not an independent risk factor for overall or attributable mortality among patients with Enterococcus faecium BSI. Independent risk factors identified in this study were exclusively comorbidities, severity and corticosteroids use.
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