Risk Factors Associated with Failure of Linezolid Therapy in Vancomycin-Resistant Enterococcus faecium Bacteremia: A Retrospective Cohort Study in a Referral Center in Mexico.
Risk Factors Associated with Failure of Linezolid Therapy in Vancomycin-Resistant Enterococcus faecium Bacteremia: A Retrospective Cohort Study in a Referral Center in Mexico.
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与万古霉素耐药屎肠球菌菌血症利奈唑胺治疗失败相关的危险因素：墨西哥转诊中心的一项回顾性队列研究。
DOI：
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发表时间：
2022
影响因子：
2.6
通讯作者：
J. Sifuentes
中科院分区：
文献类型：
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作者：
B. A. Lopez;A. Ponce;E. Ortiz;Darwin Lambraño;F. Leal;Yanet Estrella Tovar;M. Bobadilla;J. Sifuentes
我们的目的是评估与万古霉素耐药屎肠球菌（VREf）血流感染（BSI）患者30天死亡率相关的因素，这些患者接受利奈唑胺治疗，在VREf BSI患者的11年回顾性队列中。进行单因素和逐步多因素logistic回归分析，以确定30天死亡率因素。此外，对死亡率的预测协变量进行了考克斯比例风险分析。最终分析包括80名患者;指标菌血症发生30天后，42名（53%）死亡，38名（47%）存活。42例患者中有13例（31%）在前7天死亡。在多变量分析中，急性生理学和慢性健康评估II（APACHE II）评分与30天死亡率显著相关（校正比值比[aOR]，1.46; 95%置信区间[CI]：1.22-1.76; p < 0.001）。此外，持续超过48小时的VREf BSI是与30天死亡率相关的强因素（aOR，19.6; 95% CI：1.46-263; p = 0.01）。在多变量分析中，充分控制感染源显示出保护性趋势，但未达到显著性（aOR，0.19; 95% CI：0.04-1.0; p = 0.05）。考克斯比例风险分析证实，除利奈唑胺治疗外，前48小时内相同的显著死亡预测因子是保护因素（风险比0.46; 95% CI：0.23-0.92，p = 0.02）。具有高APACHE II评分和持续性菌血症的重症患者接受利奈唑胺治疗失败的风险更高。
We aimed to assess the factors associated with 30-day mortality in patients with vancomycin-resistant Enterococcus faecium (VREf) bloodstream infection (BSI) who received treatment with linezolid in an 11-year retrospective cohort of patients with VREf BSI. A univariate and stepwise multivariate logistic regression analysis was performed to determine 30-day mortality factors. Moreover, a Cox proportional hazards analysis of predictor covariates of mortality was performed. Eighty patients were included in the final analysis; 42 (53%) died and 38 (47%) survived 30 days after the index bacteremia. Thirteen patients of 42 (31%) died in the first 7 days. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score was significantly associated with 30-day mortality (adjusted odds ratio [aOR], 1.46; 95% confidence interval [CI]: 1.22-1.76; p < 0.001) in the multivariate analysis. Moreover, VREf BSI persisting for more than 48 hours was a strong factor related to 30-day mortality (aOR, 19.6; 95% CI: 1.46-263; p = 0.01). Adequate control of infection source showed a trend to be protective without reaching significance in the multivariate analysis (aOR, 0.19; 95% CI: 0.04-1.0; p = 0.05). The Cox proportional hazards analysis confirmed the same significant mortality predictor besides linezolid treatment within the first 48 hours as a protective factor (hazard ratio 0.46; 95% CI: 0.23-0.92, p = 0.02). Severely ill patients with high APACHE II score and persistent bacteremia have a higher risk of failure with linezolid therapy.
影响因子：
11.8
作者：
Zasowski, Evan J.;Claeys, Kimberly C.;Rybak, Michael J.
通讯作者：
Rybak, Michael J.