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The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections

Vancomycin-resistant enterococci infections are of great public health significance due to limited therapeutic options. We investigated epidemiological trends and risk factors of vancomycin resistance in enterococci isolates from patients with bloodstream infections in the EU/EEA from 2012 to 2018....

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Autores principales: Ayobami, Olaniyi, Willrich, Niklas, Reuss, Annicka, Eckmanns, Tim, Markwart, Robby
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448851/
https://www.ncbi.nlm.nih.gov/pubmed/32498615
http://dx.doi.org/10.1080/22221751.2020.1769500
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author Ayobami, Olaniyi
Willrich, Niklas
Reuss, Annicka
Eckmanns, Tim
Markwart, Robby
author_facet Ayobami, Olaniyi
Willrich, Niklas
Reuss, Annicka
Eckmanns, Tim
Markwart, Robby
author_sort Ayobami, Olaniyi
collection PubMed
description Vancomycin-resistant enterococci infections are of great public health significance due to limited therapeutic options. We investigated epidemiological trends and risk factors of vancomycin resistance in enterococci isolates from patients with bloodstream infections in the EU/EEA from 2012 to 2018. Routine vancomycin susceptibility data of clinical E. faecium (n = 67,022) and E. faecalis (n = 103,112) blood isolates from the European Antimicrobial Resistance Surveillance Network were analysed using descriptive statistics and multivariable regression analyses. In Europe, proportions of vancomycin-resistant E. faecium (VREFm) increased from 8.1% (95%CI 6.7–9.7%) in 2012 to 19.0% (95%CI 16.8–21.5%) in 2018. Rising VREFm proportions were observed across all European regions, both genders and all age groups except children and adolescents (1–19 years). Adults (20–59 years) and elderly (≥60 years) had an increased likelihood of VREFm compared to children and adolescents (1–19 years) (OR: 1.99 [95%CI 1.42–2.79, p < 0.001] and OR: 1.56 [95%CI 1.09–2.23, p = 0.014], respectively). Inpatients hospital units, including internal medicine and ICUs, were associated with an increased likelihood of VREFm (OR: 2.29 (95%CI 1.58–3.32, p < 0.001) compared to the emergency department which reflects patients with community origin of E. faecium infections. The mean proportion of vancomycin-resistant E. faecalis in Europe was found to be low (1.1% [95%CI 0.9–1.4%]). Local and regional authorities should intensify efforts directed at diagnostic and antimicrobial stewardship for vancomycin and all last resort drugs for the management of VREFm, particularly for hospitalized elderly patients.
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spelling pubmed-74488512020-09-10 The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections Ayobami, Olaniyi Willrich, Niklas Reuss, Annicka Eckmanns, Tim Markwart, Robby Emerg Microbes Infect Articles Vancomycin-resistant enterococci infections are of great public health significance due to limited therapeutic options. We investigated epidemiological trends and risk factors of vancomycin resistance in enterococci isolates from patients with bloodstream infections in the EU/EEA from 2012 to 2018. Routine vancomycin susceptibility data of clinical E. faecium (n = 67,022) and E. faecalis (n = 103,112) blood isolates from the European Antimicrobial Resistance Surveillance Network were analysed using descriptive statistics and multivariable regression analyses. In Europe, proportions of vancomycin-resistant E. faecium (VREFm) increased from 8.1% (95%CI 6.7–9.7%) in 2012 to 19.0% (95%CI 16.8–21.5%) in 2018. Rising VREFm proportions were observed across all European regions, both genders and all age groups except children and adolescents (1–19 years). Adults (20–59 years) and elderly (≥60 years) had an increased likelihood of VREFm compared to children and adolescents (1–19 years) (OR: 1.99 [95%CI 1.42–2.79, p < 0.001] and OR: 1.56 [95%CI 1.09–2.23, p = 0.014], respectively). Inpatients hospital units, including internal medicine and ICUs, were associated with an increased likelihood of VREFm (OR: 2.29 (95%CI 1.58–3.32, p < 0.001) compared to the emergency department which reflects patients with community origin of E. faecium infections. The mean proportion of vancomycin-resistant E. faecalis in Europe was found to be low (1.1% [95%CI 0.9–1.4%]). Local and regional authorities should intensify efforts directed at diagnostic and antimicrobial stewardship for vancomycin and all last resort drugs for the management of VREFm, particularly for hospitalized elderly patients. Taylor & Francis 2020-06-04 /pmc/articles/PMC7448851/ /pubmed/32498615 http://dx.doi.org/10.1080/22221751.2020.1769500 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Shanghai Shangyixun Cultural Communication Co., Ltd https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Articles
Ayobami, Olaniyi
Willrich, Niklas
Reuss, Annicka
Eckmanns, Tim
Markwart, Robby
The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title_full The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title_fullStr The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title_full_unstemmed The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title_short The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections
title_sort ongoing challenge of vancomycin-resistant enterococcus faecium and enterococcus faecalis in europe: an epidemiological analysis of bloodstream infections
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448851/
https://www.ncbi.nlm.nih.gov/pubmed/32498615
http://dx.doi.org/10.1080/22221751.2020.1769500
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