Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan
Background: Vancomycin-variable enterococci (VVE) are vanA-carrying Enterococcus faecium that are phenotypically susceptible to vancomycin and can only be detected using molecular methods, leading to the possibility of treatment failure and posing threats to infection control. This study aimed to de...
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Elsevier
2024-12-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118224001506 |
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| author | Chi-Jung Lu Wei-Chun Hung Zi-Han Lan Po-Liang Lu Chun-Yu Lin Yen-Hsu Chen Tun-Chieh Chen Chung-Hao Huang Ya-Ting Chang Chun-Yuan Lee Yu-Te Tsai Shang-Yi Lin |
| author_facet | Chi-Jung Lu Wei-Chun Hung Zi-Han Lan Po-Liang Lu Chun-Yu Lin Yen-Hsu Chen Tun-Chieh Chen Chung-Hao Huang Ya-Ting Chang Chun-Yuan Lee Yu-Te Tsai Shang-Yi Lin |
| author_sort | Chi-Jung Lu |
| collection | DOAJ |
| description | Background: Vancomycin-variable enterococci (VVE) are vanA-carrying Enterococcus faecium that are phenotypically susceptible to vancomycin and can only be detected using molecular methods, leading to the possibility of treatment failure and posing threats to infection control. This study aimed to determine the prevalence of VVE and its associated clinical risk factors. Methods: This retrospective study was conducted in two hospitals in southern Taiwan. Patients with phenotypically vancomycin-susceptible E. faecium bacteremia were enrolled between 2017 and 2021. VVEs were defined as isolates harboring the vanA gene that were phenotypically susceptible to vancomycin. Vancomycin-susceptible E. faecium (VSE) isolates were phenotypically susceptible to vancomycin and lacked vanA or vanB genes. Results: Of the 142 enrolled patients, 121 (85.2%) had VSE and 21 (14.8%) had VVE. Resistance rates to penicillin, tetracycline, and fosfomycin were higher in VVE isolates. Malignancy (adjusted odds ratio [aOR] = 4.87; 95% confidence interval [CI] 1.54–15.41, p = 0.007) and central venous catheter usage (aOR = 4.69; 95% CI 1.49–14.78, p = 0.008) were the independent risk factors associated with VVE bacteremia. Being male (aOR = 0.12, CI 0.03–0.44, p = 0.002) was less likely to be associated with VVE bacteremia. Although VVE was not associated with 30-day mortality (38.1% [VVE] vs. 35.5% [VSE], p = 0.822), one case of subsequent vancomycin-resistant enterococci infection in the VVE group with vancomycin treatment (4.8%, 1/21) was identified, which led to subsequent mortality. Conclusions: The prevalence of VVE was high among E. faecium isolates with vancomycin-susceptible phenotypes in southern Taiwan. Although the current study revealed that VVE bacteremia was not associated with poor clinical outcome, further multicenter surveillance survey is recommended to evaluate the possible impact of VVE on public health in Taiwan. |
| format | Article |
| id | doaj-art-0983248a340c45b981475d2acf97748c |
| institution | Kabale University |
| issn | 1684-1182 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj-art-0983248a340c45b981475d2acf97748c2024-12-19T10:53:04ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822024-12-01576926936Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern TaiwanChi-Jung Lu0Wei-Chun Hung1Zi-Han Lan2Po-Liang Lu3Chun-Yu Lin4Yen-Hsu Chen5Tun-Chieh Chen6Chung-Hao Huang7Ya-Ting Chang8Chun-Yuan Lee9Yu-Te Tsai10Shang-Yi Lin11Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Microbiology and Immunology, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanGraduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Corresponding author. Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 100 Tzyou 1st Road, Kaohsiung City, Taiwan.Background: Vancomycin-variable enterococci (VVE) are vanA-carrying Enterococcus faecium that are phenotypically susceptible to vancomycin and can only be detected using molecular methods, leading to the possibility of treatment failure and posing threats to infection control. This study aimed to determine the prevalence of VVE and its associated clinical risk factors. Methods: This retrospective study was conducted in two hospitals in southern Taiwan. Patients with phenotypically vancomycin-susceptible E. faecium bacteremia were enrolled between 2017 and 2021. VVEs were defined as isolates harboring the vanA gene that were phenotypically susceptible to vancomycin. Vancomycin-susceptible E. faecium (VSE) isolates were phenotypically susceptible to vancomycin and lacked vanA or vanB genes. Results: Of the 142 enrolled patients, 121 (85.2%) had VSE and 21 (14.8%) had VVE. Resistance rates to penicillin, tetracycline, and fosfomycin were higher in VVE isolates. Malignancy (adjusted odds ratio [aOR] = 4.87; 95% confidence interval [CI] 1.54–15.41, p = 0.007) and central venous catheter usage (aOR = 4.69; 95% CI 1.49–14.78, p = 0.008) were the independent risk factors associated with VVE bacteremia. Being male (aOR = 0.12, CI 0.03–0.44, p = 0.002) was less likely to be associated with VVE bacteremia. Although VVE was not associated with 30-day mortality (38.1% [VVE] vs. 35.5% [VSE], p = 0.822), one case of subsequent vancomycin-resistant enterococci infection in the VVE group with vancomycin treatment (4.8%, 1/21) was identified, which led to subsequent mortality. Conclusions: The prevalence of VVE was high among E. faecium isolates with vancomycin-susceptible phenotypes in southern Taiwan. Although the current study revealed that VVE bacteremia was not associated with poor clinical outcome, further multicenter surveillance survey is recommended to evaluate the possible impact of VVE on public health in Taiwan.http://www.sciencedirect.com/science/article/pii/S1684118224001506BacteremiaEnterococcusVancomycinVancomycin-variable Enterococcus faeciumVVE |
| spellingShingle | Chi-Jung Lu Wei-Chun Hung Zi-Han Lan Po-Liang Lu Chun-Yu Lin Yen-Hsu Chen Tun-Chieh Chen Chung-Hao Huang Ya-Ting Chang Chun-Yuan Lee Yu-Te Tsai Shang-Yi Lin Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan Journal of Microbiology, Immunology and Infection Bacteremia Enterococcus Vancomycin Vancomycin-variable Enterococcus faecium VVE |
| title | Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan |
| title_full | Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan |
| title_fullStr | Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan |
| title_full_unstemmed | Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan |
| title_short | Characteristics and Prevalence of Vancomycin-variable Enterococcus faecium bacteremia in southern Taiwan |
| title_sort | characteristics and prevalence of vancomycin variable enterococcus faecium bacteremia in southern taiwan |
| topic | Bacteremia Enterococcus Vancomycin Vancomycin-variable Enterococcus faecium VVE |
| url | http://www.sciencedirect.com/science/article/pii/S1684118224001506 |
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