Journal Article

Glycopeptide Resistance among Coagulase-Negative Staphylococci that Cause Bacteremia: Epidemiological and Clinical Findings from a Case-Control Study

Evelina Tacconelli, Mario Tumbarello, Katleen de Gaetano Donati, Manola Bettio, Teresa Spanu, Fiammetta Leone, Leonardo A. Sechi, Stefania Zanetti, Giovanni Fadda and Roberto Cauda

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 10, pages 1628-1635
Published in print November 2001 | ISSN: 1058-4838
Published online November 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323676
Glycopeptide Resistance among Coagulase-Negative Staphylococci that Cause Bacteremia: Epidemiological and Clinical Findings from a Case-Control Study

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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 coagulase-negative 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.

Journal Article.  4228 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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