Tacconelli, Evelina and Tumbarello, Mario and De Gaetano Donati, Katleen and Bettio, Manola and Spanu, Teresa and Leone, Fiammetta and Sechi, Leonardo Antonio and Zanetti, Stefania Anna Lucia and Fadda, Giovanni and Cauda, Roberto (2001) Glycopeptide resistance among coagulase- negative staphylococci that cause bacteremia: epidemiological and clinical findings from a case-control study. Clinical Infectious Diseases, Vol. 33 , p. 1628-1635. eISSN 1537-6591. Article.
A 1-year prospective case-control study (ratio of control patients to case patients, 3:1) was performed to assess the incidence, risk factors, and genotypic patterns of bacteremia caused by glycopeptide-resistant coagulasenegative staphylococci (CoNS) and their correlation with hospital glycopeptide use. Among 535 subjects with CoNS bacteremia, 20 subjects had a glycopeptide-resistant strain (19 strains were resistant to teicoplanin and 1 was resistant to both teicoplanin and vancomycin). The percentage of resistant isolates recovered in 1 year was 8% in intensive care units and 3% and 2% in medical and surgical wards, respectively. Genotypic analysis of resistant strains showed different patterns with a high degree of polymorphism. Use of glycopeptides in individual wards was not statistically associated with the percentage of resistance. Previous exposure to β-lactams and glycopeptides, multiple hospitalization in the previous year, and concomitant pneumonia were significantly associated with the onset of glycopeptide-resistant CoNS bacteremia. Mortality rates were 25% among case patients and 18% among control patients, and they were significantly higher among patients who presented with concomitant pneumonia and a high Acute Physiology and Chronic Health Evaluation III score.
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