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Volume 10, Number 7—July 2004

Research

Nosocomial Infection with Vancomycin-dependent Enterococci1

Paul A. Tambyah*Comments to Author , John A. Marx*, and Dennis G. Maki*
Author affiliations: *University of Wisconsin Medical School, Madison, Wisconsin, USA

Main Article

Table

Clinical and epidemiologic features of patients with nosocomial enterococcal infections and uninfected control patientsa

Features VDE
(n = 3) VRE
(n = 10) Uninfected control patients
(n = 10)
Age, y, mean ± SD
39.0 ± 7.5
41.7 ± 20.2
51.1 ± 13.0
Sex, no.

Male
0
5
7
Female
3
5
3
Duration of hospitalization, days, mean ± SD
41.7 ± 13
33.6 ± 12.1
37.6 ± 44.7
ICU stay, days, mean ± SD
9.3 ± 4.0
1.0 ± 1.9b
7.4 ± 7.4
Site of nosocomial enterococcal infection

Primary bloodstream infection
0
5
0
Surgical wound infection
1
2
0
Intraabdominal infection
1
1
0
Urinary tract Infection
1
1
0
Service, no.

Medicine or pediatrics
1
5
5
Surgery
2
5
5
Associated conditions, no.

Malignancy
1
4
2
Diabetes mellitus
2
3
4
Renal failure
3
3
4
Trauma
0
2
0
Transplant recipient
3
4
2
APACHE II score, mean ± SD
18.7 ± 2.1
15.1 ± 6.7
19.4 ± 10.0
Serum creatinine, mg/dL, mean ± SD
2.8 ± 0.5b
1.5 ± 0.8
1.9 ± 1.8
Days on antimicrobial agent

Vancomycin
27.3±13.7c
9.1±10.3
5.7±7.6
Aminoglycosides
11.3±6.7
9.7±9.8
2.5±5.1
First- or second-generation cephalosporins
0.7±0.6
1.1±2.2
3.6±7.5
Third-generation cephalosporins
17.0±11.4d
15.6±11.9e
2.9±4.8
Quinolones
10.3±5.5
8.0±9.2
3.4±4.8
Clindamycin
2.3±4.0
7.1±11.7
1.2±3.8
Metronidazole
4.3±7.5
4.4±6.3
1.8±3.8
Trimethoprim-sulfamethoxazole
32.7±18.0d
14.6±19.2
2.7±5.7
Others
1.0±1.7
5.6±9.5
4.8±9.6
Total 106.3±44.7d 83.5±29.4e 28.6±23.1

aVDE, vancomycin-dependent enterococci; VRE, vancomycin-resistant enterococci; ICU, intensive care unit; APACHE, Acute Physiology and Chronic Health Evaluation score.
bVRE vs. controls, p = 0.03.
cVDE vs. VRE, p = 0.02.
dVDE vs. VRE, p = 0.03.
eVDE vs. controls, p < 0.01.
fVRE vs. controls, p < 0.01.

Main Article

1Presented in part at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA, September 24–27, 1998.

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