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Daptomycin-Resistant Enterococcus Bacteremia Is Associated with Prior Daptomycin Use and Increased Mortality after Liver Transplantation
Resource type
Journal Article
Authors/contributors
- Lee, Rachael A (Author)
- Goldman, Jason (Author)
- Haidar, Ghady (Author)
- Lewis, Jessica (Author)
- Arif, Sana (Author)
- Hand, Jonathan (Author)
- La Hoz, Ricardo M (Author)
- Pouch, Stephanie (Author)
- Holaday, Eric (Author)
- Clauss, Heather (Author)
- Kaye, Keith S (Author)
- Nellore, Anoma (Author)
Title
Daptomycin-Resistant Enterococcus Bacteremia Is Associated with Prior Daptomycin Use and Increased Mortality after Liver Transplantation
Abstract
Risk factors for acquisition of vancomycin-resistant Enterococcus (VRE) include immunosuppression, antibiotic exposure, indwelling catheters, and manipulation of the gastrointestinal tract, all of which occur in liver transplant recipients. VRE infections are documented in liver transplantation (LT); however, only one single center study has assessed the impact daptomycin-resistant Enterococcus (DRE) in this patient population.We conducted a retrospective multicenter cohort study comparing liver transplant recipients with either VRE or DRE bacteremia. The primary outcome was death within one year of transplantation. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios for outcomes of interest.We identified 139 cases of Enterococcus bacteremia following LT, of which 78% were VRE and 22% were DRE. When adjusted for total ICU days in the first transplant year, liver-kidney transplantation, and calcineurin inhibitor use, patients with DRE bacteremia were 2.65 times more likely to die within one year of transplantation (aOR 2.648 [1.025-6.840], p = 0.044). Prior daptomycin exposure was found to be an independent predictor of DRE bacteremia (aOR 30.62 (10.087-92.955), p <0.001).In this multicenter study of LT recipients with Enterococcus bacteremia, DRE bacteremia was associated with higher 1-year mortality rates when compared to VRE bacteremia. Our data provide strong support for dedicated infection prevention and antimicrobial stewardship efforts for transplant patients. Further research is needed to support the development of better antibiotics for DRE and practical guidance focusing on identification and prevention of colonization and subsequent infection in liver transplant recipients at high risk for DRE bacteremia.
Publication
Open Forum Infectious Diseases
Date
January 22, 2022
Pages
ofab659
Journal Abbr
Open Forum Infectious Diseases
Accessed
2/3/22, 8:53 AM
ISSN
2328-8957
Library Catalog
Silverchair
Citation
Lee, R. A., Goldman, J., Haidar, G., Lewis, J., Arif, S., Hand, J., La Hoz, R. M., Pouch, S., Holaday, E., Clauss, H., Kaye, K. S., & Nellore, A. (2022). Daptomycin-Resistant Enterococcus Bacteremia Is Associated with Prior Daptomycin Use and Increased Mortality after Liver Transplantation. Open Forum Infectious Diseases, ofab659. https://doi.org/10.1093/ofid/ofab659
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