Volume 10, Number 7—July 2004
Research
Nosocomial Infection with Vancomycin-dependent Enterococci1
Paul A. Tambyah*
, John A. Marx*, and Dennis G. Maki*
, John A. Marx*, and Dennis G. Maki*
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.
1Presented in part at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA, September 24–27, 1998.
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