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Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus

BACKGROUND: Daptomycin non-susceptible enterococci (DNSE) are emerging as an important cause of healthcare-associated infection, however little is known about the epidemiology of DNSE. At the University of Iowa Hospitals and Clinics (UIHC) an increase in the frequency of patients infected and/or col...

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Autores principales: Storm, Jeremy C, Diekema, Daniel J, Kroeger, Jennifer S, Johnson, Sarah J, Johannsson, Birgir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3436660/
https://www.ncbi.nlm.nih.gov/pubmed/22958379
http://dx.doi.org/10.1186/2047-2994-1-19
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author Storm, Jeremy C
Diekema, Daniel J
Kroeger, Jennifer S
Johnson, Sarah J
Johannsson, Birgir
author_facet Storm, Jeremy C
Diekema, Daniel J
Kroeger, Jennifer S
Johnson, Sarah J
Johannsson, Birgir
author_sort Storm, Jeremy C
collection PubMed
description BACKGROUND: Daptomycin non-susceptible enterococci (DNSE) are emerging as an important cause of healthcare-associated infection, however little is known about the epidemiology of DNSE. At the University of Iowa Hospitals and Clinics (UIHC) an increase in the frequency of patients infected and/or colonized with DNSE has occurred. The goals of this study were to evaluate potential factors associated with the development of DNSE colonization and/or infection and to compare the characteristics of patients with prior daptomycin exposure to those without prior daptomycin exposure. METHODS: The study is a retrospective case-series involving all patients with DNSE infection and/or colonization at UIHC, a 734-bed academic referral center, from June 1, 2005 to June 1, 2011. RESULTS: The majority of patients with DNSE colonization and/or infection had prior daptomycin exposure (15 of 25; 60%), a concomitant gastrointestinal process (19 of 25; 76%), or were immunosuppressed (21 of 25; 84%). DNSE infection was confirmed in 17 of 25 (68%) patients, including 9 patients with bacteremia. Twelve of 17 (71%) patients with DNSE infection had prior daptomycin exposure, including 7 of 9 (78%) patients with bacteremia. Compared to patients without prior daptomycin exposure, patients with prior daptomycin exposure were less likely to harbor E. faecalis (0% vs. 33%; p = 0.019). A high proportion of patients (10 of 25; 40%) died during their hospitalizations. Most enterococcal isolates were E. faecium (86%), and were vancomycin-resistant (72%). Molecular typing revealed a diverse population of DNSE. CONCLUSIONS: Prior daptomycin exposure, immunosuppression, and/or a concomitant gastrointestinal process, may be associated with the development of DNSE. PFGE revealed a diverse population of DNSE, which along with both increasing numbers of DNSE detected yearly and increasing annual rates of daptomycin usage, suggests the emergence of DNSE under antimicrobial pressure.
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spelling pubmed-34366602012-09-08 Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus Storm, Jeremy C Diekema, Daniel J Kroeger, Jennifer S Johnson, Sarah J Johannsson, Birgir Antimicrob Resist Infect Control Research BACKGROUND: Daptomycin non-susceptible enterococci (DNSE) are emerging as an important cause of healthcare-associated infection, however little is known about the epidemiology of DNSE. At the University of Iowa Hospitals and Clinics (UIHC) an increase in the frequency of patients infected and/or colonized with DNSE has occurred. The goals of this study were to evaluate potential factors associated with the development of DNSE colonization and/or infection and to compare the characteristics of patients with prior daptomycin exposure to those without prior daptomycin exposure. METHODS: The study is a retrospective case-series involving all patients with DNSE infection and/or colonization at UIHC, a 734-bed academic referral center, from June 1, 2005 to June 1, 2011. RESULTS: The majority of patients with DNSE colonization and/or infection had prior daptomycin exposure (15 of 25; 60%), a concomitant gastrointestinal process (19 of 25; 76%), or were immunosuppressed (21 of 25; 84%). DNSE infection was confirmed in 17 of 25 (68%) patients, including 9 patients with bacteremia. Twelve of 17 (71%) patients with DNSE infection had prior daptomycin exposure, including 7 of 9 (78%) patients with bacteremia. Compared to patients without prior daptomycin exposure, patients with prior daptomycin exposure were less likely to harbor E. faecalis (0% vs. 33%; p = 0.019). A high proportion of patients (10 of 25; 40%) died during their hospitalizations. Most enterococcal isolates were E. faecium (86%), and were vancomycin-resistant (72%). Molecular typing revealed a diverse population of DNSE. CONCLUSIONS: Prior daptomycin exposure, immunosuppression, and/or a concomitant gastrointestinal process, may be associated with the development of DNSE. PFGE revealed a diverse population of DNSE, which along with both increasing numbers of DNSE detected yearly and increasing annual rates of daptomycin usage, suggests the emergence of DNSE under antimicrobial pressure. BioMed Central 2012-05-29 /pmc/articles/PMC3436660/ /pubmed/22958379 http://dx.doi.org/10.1186/2047-2994-1-19 Text en Copyright ©2012 Storm et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Storm, Jeremy C
Diekema, Daniel J
Kroeger, Jennifer S
Johnson, Sarah J
Johannsson, Birgir
Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title_full Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title_fullStr Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title_full_unstemmed Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title_short Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
title_sort daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3436660/
https://www.ncbi.nlm.nih.gov/pubmed/22958379
http://dx.doi.org/10.1186/2047-2994-1-19
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