PMID- 26953719
OWN - NLM
STAT- MEDLINE
DCOM- 20170928
LR  - 20170928
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 18
IP  - 3
DP  - 2016 Jun
TI  - A single-center experience with infections due to daptomycin-nonsusceptible 
      Enterococcus faecium in liver transplant recipients.
PG  - 341-53
LID - 10.1111/tid.12523 [doi]
AB  - BACKGROUND: Infections caused by vancomycin-resistant Enterococcus faecium (VRE) 
      are a major cause of morbidity and mortality in the liver transplant population. 
      Daptomycin (DAP) is often used to treat infections caused by VRE, but DAP 
      nonsusceptibility in Enterococcus is increasing. METHOD: Patients with 
      DAP-nonsusceptible Enterococcus (DNSE) infections who had undergone liver 
      transplantation between January 1, 2010 and July 31, 2014 were retrospectively 
      reviewed. A convenience sample of DNSE isolates was analyzed by pulsed-field gel 
      electrophoresis (PFGE). RESULTS: We identified 14 liver transplant recipients 
      (LTRs) who developed DNSE infections post transplantation. Postoperative 
      complications were common, and most patients required repeat abdominal surgery 
      within 90 days of transplantation. The initial DNSE culture was taken a median of 
      74.5 days post transplant and was secondary to an intra-abdominal infection in 
      all but 1 patient. Half of patients were VRE colonized before or at the time of 
      organ transplantation, and all those who were not VRE colonized at the time of 
      transplantation later became colonized, a median of 27 days post transplant. 
      Overall mortality in this cohort was 71%. PFGE did not demonstrate genetic 
      relatedness among DNSE isolates. CONCLUSION: This study, the largest published 
      series to our knowledge of DNSE infections in LTRs, demonstrates that these 
      infections occur in patients with serious surgical complications and are 
      associated with high morbidity and mortality. Established risk factors for VRE 
      infection were common, as was DAP exposure. Although many risk factors for DNSE 
      infection cannot be changed, this case series identifies several potentially 
      modifiable variables. Further work is needed to identify interventions to 
      decrease the risk of developing DNSE infections in this complex patient 
      population.
CI  - (c) 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Lewis, J D
AU  - Lewis JD
AD  - Division of Infectious Diseases & International Health, Department of Medicine, 
      University of Virginia Health System, Charlottesville, Virginia, USA.
FAU - Enfield, K B
AU  - Enfield KB
AD  - Division of Pulmonary & Critical Care Medicine, Department of Medicine, 
      University of Virginia Health System, Charlottesville, Virginia, USA.
AD  - Office of Hospital Epidemiology/Infection Prevention & Control, University of 
      Virginia Health System, Charlottesville, Virginia, USA.
FAU - Cox, H L
AU  - Cox HL
AD  - Division of Infectious Diseases & International Health, Department of Medicine, 
      University of Virginia Health System, Charlottesville, Virginia, USA.
FAU - Mathers, A J
AU  - Mathers AJ
AD  - Division of Infectious Diseases & International Health, Department of Medicine, 
      University of Virginia Health System, Charlottesville, Virginia, USA.
FAU - Sifri, C D
AU  - Sifri CD
AD  - Division of Infectious Diseases & International Health, Department of Medicine, 
      University of Virginia Health System, Charlottesville, Virginia, USA.
AD  - Office of Hospital Epidemiology/Infection Prevention & Control, University of 
      Virginia Health System, Charlottesville, Virginia, USA.
LA  - eng
PT  - Journal Article
DEP - 20160422
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
RN  - 0 (Anti-Bacterial Agents)
RN  - NWQ5N31VKK (Daptomycin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*pharmacology
MH  - Daptomycin/*pharmacology
MH  - Drug Resistance, Bacterial
MH  - Drug Resistance, Multiple
MH  - Electrophoresis, Gel, Pulsed-Field
MH  - Enterococcus faecium/*drug effects/genetics
MH  - Female
MH  - Gram-Positive Bacterial Infections/epidemiology/*microbiology
MH  - Humans
MH  - Incidence
MH  - Liver Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Vancomycin Resistance
OTO - NOTNLM
OT  - Enterococcus
OT  - daptomycin nonsusceptibility
OT  - daptomycin resistance
OT  - liver transplant
OT  - vancomycin-resistant Enterococcus
EDAT- 2016/03/10 06:00
MHDA- 2017/09/29 06:00
CRDT- 2016/03/09 06:00
PHST- 2015/07/22 00:00 [received]
PHST- 2015/11/11 00:00 [revised]
PHST- 2016/01/10 00:00 [accepted]
PHST- 2016/03/09 06:00 [entrez]
PHST- 2016/03/10 06:00 [pubmed]
PHST- 2017/09/29 06:00 [medline]
AID - 10.1111/tid.12523 [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2016 Jun;18(3):341-53. doi: 10.1111/tid.12523. Epub 2016 Apr 
      22.