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The Application of Open Searching-based Approaches for the Identification of Acinetobacter baumannii O-linked Glycopeptides
Published on: November 2, 2021
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Glycopeptide use is associated with increased mortality in Enterococcus faecalis bacteraemia.
Hong Foo1, Mathew Chater2, Michael Maley2
1Department of Microbiology and Infectious Diseases, Sydney South West Pathology Service, Liverpool, Sydney, NSW, Australia Antibiotic Resistance and Mobile Genetic Elements Group, Microbiology and Infectious Diseases Unit, School of Medicine, University of Western Sydney, Sydney, NSW, Australia hongfoo@ymail.com.
The Journal of Antimicrobial Chemotherapy
|April 19, 2014
Summary
For Enterococcus faecalis bacteraemia, β-lactam antibiotics are associated with lower mortality than glycopeptides. β-lactams should be considered first-line therapy for susceptible infections, improving patient outcomes.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Pharmacology
Background:
- Enterococci are a significant cause of hospital-acquired and community infections.
- Bacteraemia is a common presentation of enterococcal infections.
- The impact of specific antibiotic classes on outcomes in Enterococcus faecalis bacteraemia is not well-defined.
Purpose of the Study:
- To investigate the impact of antibiotic choice on patient outcomes in Enterococcus faecalis bacteraemia.
- To compare mortality rates between β-lactam and glycopeptide therapies for Enterococcus faecalis bacteraemia.
Main Methods:
- Retrospective cohort study at Liverpool and Bankstown Lidcombe Hospitals, Sydney, Australia (2006-2013).
- Review of medical records and laboratory data for consecutive Enterococcus faecalis bacteraemias.
- Analysis of clinical and microbiological data for patients receiving appropriate β-lactam or glycopeptide therapy.
Main Results:
- 172 episodes of Enterococcus faecalis bacteraemia received appropriate therapy (126 β-lactam, 46 glycopeptide).
- 30-day all-cause mortality was 15.1%, significantly higher in the glycopeptide group (26.1%) vs. β-lactam group (11.1%).
- Glycopeptide therapy (OR 2.46), high APACHE II score (OR 1.10), and malignancy (OR 2.58) were independent predictors of 30-day mortality.
Conclusions:
- Glycopeptide use is linked to increased mortality in Enterococcus faecalis bacteraemia.
- For β-lactam-susceptible Enterococcus faecalis bacteraemia, β-lactams are recommended as first-line treatment.
- Antibiotic selection significantly impacts outcomes in Enterococcus faecalis bacteraemia.
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