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Related Experiment Video

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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291

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Published on: December 10, 2016

Association between vancomycin-resistant Enterococci bacteremia and ceftriaxone usage.

James A McKinnell¹, Danielle F Kunz, Eric Chamot

¹Infectious Disease Clinical Outcomes Research Unit, Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USA. Dr.McKinnell@yahoo.com

Infection Control and Hospital Epidemiology

|June 7, 2012

Summary

Increased ceftriaxone use correlated with higher vancomycin-resistant enterococci bloodstream infections (VRE-BSI). Limiting ceftriaxone may help reduce hospital-acquired VRE-BSI, improving patient outcomes.

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Published on: July 24, 2021

Area of Science:

Infectious Diseases
Hospital Epidemiology
Antimicrobial Stewardship

Background:

Vancomycin-resistant enterococci (VRE) pose a significant public health threat, increasing patient mortality and healthcare costs.
The link between hospital antibiotic use and VRE incidence is not well understood, despite animal studies suggesting a ceftriaxone-VRE association.

Purpose of the Study:

To investigate the association between antimicrobial usage and vancomycin-resistant enterococci bloodstream infection (VRE-BSI) incidence.
To test the hypothesis that increased ceftriaxone usage is linked to a higher incidence of VRE-BSI.

Main Methods:

Retrospective cohort study conducted at a 900-bed urban tertiary care hospital from 2005 to 2008.
Antimicrobial usage quantified as days of therapy (DOTs) per 1,000 patient-days; VRE-BSI incidence calculated as cases per 1,000 patient-days.
Negative binomial regression used to analyze associations between antimicrobial usage and VRE-BSI at hospital and care-unit levels.

Main Results:

VRE-BSI incidence rose from 0.06 to 0.17 per 1,000 patient-days during the study period.
Prior-month ceftriaxone DOTs were significantly associated with increased VRE-BSI incidence (IRR, 1.38 per 10 DOTs; P = .005).
Cephalosporin (class) or vancomycin usage was not predictive of VRE-BSI, nor were other specific antibiotics when analyzed individually.

Conclusions:

Prior-month ceftriaxone usage, but not cephalosporin or vancomycin use, was associated with VRE-BSI incidence.
Findings suggest that antimicrobial stewardship programs targeting ceftriaxone use could potentially decrease nosocomial VRE-BSI.
Intensive care unit type was also identified as a factor related to VRE-BSI incidence.