Skip to main content Accessibility help
×
Home

Vancomycin-resistant enterococci with reduced daptomycin susceptibility in Singapore: prevalence and associated factors

  • A. CHOW (a1), N. N. WIN (a1), P. Y. NG (a1), W. LEE (a2) and M. K. WIN (a1)...

Summary

Prevalence of vancomycin-resistant enterococci (VRE) and use of daptomycin are increasing in Asia. To determine the prevalence of daptomycin non-susceptible enterococci (DNSE) and understand factors associated with reduced daptomycin susceptibility in VRE, we conducted a case-control study in a 1600-bed adult tertiary hospital in Singapore. All VRE isolates from inpatients in 2012 were tested for daptomycin susceptibility. Patients with VRE isolates of daptomycin minimum inhibitory concentration (MIC) ⩾3 µg/ml were classified as daptomycin-reduced susceptible VRE (DRS-VRE) and those with daptomycin MIC <3 µg/ml classified as daptomycin-susceptible VRE (DS-VRE). Medical records were reviewed for clinical and epidemiological data. None of 243 VRE isolates had MIC >4 µg/ml (DNSE). About half (135, 55%) had reduced susceptibility to daptomycin (MIC 3–4 µg/ml). None in the DS-VRE group had prior exposure to daptomycin. After adjusting for age, gender, comorbidity, hospitalization duration, surgical history, indwelling device use, and duration of antibiotic exposure in the prior 3 months, >1 movement between wards [odds ratio (OR) 0·35, 95% confidence interval (CI) 0·16–0·74, P = 0·006] and minocycline resistance (OR 0·45, 95% CI 0·25–0·84, P = 0·011) were independently associated with DRS-VRE. Our study suggests that daptomycin exposure, >1 movement between wards, and resistance to minocycline, were associated with reduced daptomycin susceptibility in VRE.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Vancomycin-resistant enterococci with reduced daptomycin susceptibility in Singapore: prevalence and associated factors
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Vancomycin-resistant enterococci with reduced daptomycin susceptibility in Singapore: prevalence and associated factors
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Vancomycin-resistant enterococci with reduced daptomycin susceptibility in Singapore: prevalence and associated factors
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: A. Chow, 11 Jalan Tan Tock Seng, Singapore 308433. (Email: Angela_Chow@ttsh.com.sg)

References

Hide All
1. Uttley, AH, et al. Vancomycin-resistant enterococci. Lancet 1988; 1: 5758.
2. Murray, BE. Vancomycin-resistant enterococcal infections. New England Journal of Medicine 2000; 342: 710721.
3. Landman, D, Quale, JM. Management of infections due to resistant enterococci: a review of therapeutic options. Journal of Antimicrobial Chemotherapy 1997; 40: 161170.
4. Wisplinghoff, H, et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clinical Infectious Diseases 2004; 39: 309317.
5. Canton, R, et al. A potential role for daptomycin in enterococcal infections: what is the evidence? Journal of Antimicrobial Chemotherapy 2010; 65: 11261136.
6. Fraher, MH, et al. Daptomycin-resistant Enteroccoccus faecium in a patient with no prior exposure to daptomycin. Journal of Hospital Infection 2007; 65: 376378.
7. Kelesidis, T, et al. Case-control study comparing de novo and daptomycin-exposed daptomycin-nonsusceptible enterococcus infections. Antimicrobial Agents Chemotherapy 2012; 56: 21502152.
8. Palmer, KL, et al. Genetic basis for daptomycin resistance in enterococci. Antimicrobial Agents Chemotherapy 2011; 55: 33453356.
9. Storm, JC, et al. Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus. Antimicrobial Resistance and Infection Control 2012; 1: 19.
10. Kelesidis, T, et al. Daptomycin nonsusceptible enterococci: an emerging challenge for clinicians. Clinical Infectious Diseases 2011; 52: 228234.
11. Hsu, LY, et al. Six cases of daptomycin-non-susceptible Staphylococcus aureus bacteraemia in Singapore. Journal of Medical Microbiology 2010; 59: 15091513.
12. Molton, JS, et al. The global spread of healthcare-associated multidrug-resistant bacteria: a perspective from Asia. Clinical Infectious Diseases 2013; 56: 13101318.
13. Abele-Horn, M, et al. Validation of VITEK 2 version 4.01 software for detection, identification, and classification of glycopeptide-resistant enterococci. Journal of Clinical Microbiology 2006; 44: 7176.
14. Dutka-Malen, S, Evers, S, Courvalin, P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. Journal of Clinical Microbiology 1995; 33: 1434.
15. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 20th informational supplement, 2012; Wayne, PA (CLSI document M100-S22).
16. Charlson, ME, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 1987; 40: 373383.
17. Tse, H, et al. National surveillance on vancomycin-resistant Enterococcus faecium in Taiwan: emergence and widespread of ST414 and a Tn1546-Like element with simultaneous insertion of IS1251-like and IS1678. PLoS ONE 2014; 9: e115555.
18. McKinnell, JA and Arias, CA. Linezolid vs daptomycin for vancomycin-resistant enterococci: the evidence gap between trials and clinical experience [Editorial Commentary]. Clinical Infectious Diseases 2015; 61: 879882.
19. Munita, JM, et al. Correlation between mutations in liaFSR of Enterococcus faecium and MIC of daptomycin: revisiting daptomycin breakpoints. Antimicrobial Agents and Chemotherapy 2012; 56: 43544359.
20. Humphries, RM, et al. Genotypic and phenotypic evaluation of the evolution of high-level daptomycin nonsusceptibility in vancomycin-resistant Enterococcus faecium. Antimicrobial Agents and Chemotherapy 2012; 56: 60516053.
21. Judge, T, et al. Epidemiology of Vancomycin-resistant enterococci with reduced susceptibility to daptomycin. Infection Control and Hospital Epidemiology 2012; 33: 12501254.
22. Descourouez, JL, et al. Fosfomycin synergy in vitro with amoxicillin, daptomycin, and linezolid against vancomycin-resistant enterococcus faecium from renal transplant patients with infected urinary stents. Antimicrobial Agents and Chemotherapy 2012; 57: 15181520.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed