Influence of minimum inhibitory concentration in clinical outcomes of Enterococcus faecium bacteremia treated with daptomycin: Is it Time to change the breakpoint?

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dc.contributor.authorShukla, Bhavarth S.
dc.contributor.authorShelburne, Samuel A.
dc.contributor.authorReyes, Katherine C.
dc.contributor.authorKamboj, Mini
dc.contributor.authorLewis, Jessica D.
dc.contributor.authorRincon Núñez, Sandra
dc.contributor.authorReyes, Jinnethe
dc.contributor.authorCarvajal Ortiz, Lina Paola
dc.contributor.authorpanesso, diana
dc.contributor.authorSifri, Costi
dc.contributor.authorZervos, Marcus John
dc.contributor.authorPamer, Eric G.
dc.contributor.authorTran, Truc T.
dc.contributor.authorAdachi, Javier
dc.contributor.authorMunita, Jose M.
dc.contributor.authorHasbun, Rodrigo
dc.contributor.authorArias, César A.
dc.contributor.orcidPanesso, Diana [0000-0002-4049-9702]
dc.contributor.orcidRincon Núñez, Sandra [0000-0002-8482-4554]
dc.contributor.orcidCarvajal Ortiz, Lina Paola [0000-0001-8301-8836]
dc.date.accessioned2020-07-16T14:48:43Z
dc.date.available2020-07-16T14:48:43Z
dc.date.issued2016
dc.description.abstractenglishBackground. Daptomycin has become a front-line antibiotic for multidrug-resistant Enterococcus faecium bloodstream infections (BSIs). We previously showed that E. faecium strains with daptomycin minimum inhibitory concentrations (MICs) in the higher end of susceptibility frequently harbor mutations associated with daptomycin resistance. We postulate that patients with E. faecium BSIs exhibiting daptomycin MICs of 3–4 µg/mL treated with daptomycin are more likely to have worse clinical outcomes than those exhibiting daptomycin MICs ≤2 µg/mL. Methods. We conducted a multicenter retrospective cohort study that included adult patients with E. faecium BSI for whom initial isolates, follow-up blood culture data, and daptomycin administration data were available. A central laboratory performed standardized daptomycin MIC testing for all isolates. The primary outcome was microbiologic failure, defined as clearance of bacteremia ≥4 days after the index blood culture. The secondary outcome was all-cause in-hospital mortality. Results. A total of 62 patients were included. Thirty-one patients were infected with isolates that exhibited daptomycin MICs of 3–4 µg/mL. Overall, 34 patients had microbiologic failure and 25 died during hospitalization. In a multivariate logistic regression model, daptomycin MICs of 3–4 µg/mL (odds ratio [OR], 4.7 [1.37–16.12]; P = .014) and immunosuppression (OR, 5.32 [1.20–23.54]; P = .028) were significantly associated with microbiologic failure. Initial daptomycin dose of ≥8 mg/kg was not significantly associated with evaluated outcomes. Conclusions. Daptomycin MICs of 3–4 µg/mL in the initial E. faecium blood isolate predicted microbiological failure of daptomycin therapy, suggesting that modification in the daptomycin breakpoint for enterococci should be considered.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1093/cid/ciw173
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn1537-6591
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlhttps://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/3522
dc.language.isoeng
dc.publisherOxford University Pressspa
dc.publisher.journalClinical infectious diseasesspa
dc.relation.ispartofseriesClinical infectious diseases, 1537-6591, Vol. 62, Nro. 12. 2016, p. 1514-1520spa
dc.relation.urihttps://academic.oup.com/cid/article/62/12/1514/1745220
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsAcceso abierto
dc.rights.creativecommons2016-04-03
dc.rights.localAcceso abiertospa
dc.subject.decsAntibacterianosspa
dc.subject.decsEnterococcus faeciumspa
dc.subject.decsDesnutriciónspa
dc.subject.keywordsE. faeciumspa
dc.subject.keywordsDaptomycinspa
dc.subject.keywordsMICspa
dc.titleInfluence of minimum inhibitory concentration in clinical outcomes of Enterococcus faecium bacteremia treated with daptomycin: Is it Time to change the breakpoint?spa
dc.title.translatedInfluence of minimum inhibitory concentration in clinical outcomes of Enterococcus faecium bacteremia treated with daptomycin: Is it Time to change the breakpoint?spa
dc.type.coarhttps://purl.org/coar/resource_type/c_6501
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículo de revista

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