Ampicillin-resistant and vancomycin-susceptible Enterococcus faecium bacteremia: a clinical narrative review

Introduction: Enterococcus faecium is a commensal microorganism that can cause infections such as bacteremia. Incidence of ampicillin-resistant and vancomycin-susceptible E. faecium (EfARSV) bacteremia is on the rise, and the mortality rate is high. Despite much data, the most appropriate treatment...

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Detalles Bibliográficos
Autores: Echeverría Esnal, Daniel, Sorli Redó, M. Luisa, Navarrete Rouco, Maria Eugenia, Prim, Núria, Barceló-Vidal, Jaime, Conde Estévez, David, Milagro Montero, Maria, Martín-Ontiyuelo, Clara, Horcajada Gallego, Juan Pablo, Grau Cerrato, Santiago
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/60151
Acceso en línea:http://hdl.handle.net/10230/60151
http://dx.doi.org/10.1080/14787210.2023.2223977
Access Level:acceso abierto
Palabra clave:Bacteremia
Enterococcus faecium
Bloodstream infection
Daptomycin
Linezolid
Oritavancin
Teicoplanin
Vancomycin
Descripción
Sumario:Introduction: Enterococcus faecium is a commensal microorganism that can cause infections such as bacteremia. Incidence of ampicillin-resistant and vancomycin-susceptible E. faecium (EfARSV) bacteremia is on the rise, and the mortality rate is high. Despite much data, the most appropriate treatment remains a question. Areas covered: This article mostly reviews the relevant aspects of EfARSV bacteremia: microbiology, gastrointestinal tract colonization and invasion, antibiotic resistance, epidemiology, risk factors, mortality, and treatment, including pharmacologic components of employed agents and related clinical evidence. A literature search was conducted on PubMed on 31 July 2022, which was updated on 15 November 2022. Expert opinion: EfARSV bacteremia presents high mortality. However, it is uncertain whether mortality is attributable to or a marker of severity/comorbidities. Considering its antibiotic resistance pattern, EfARSV is considered a difficult-to-treat microorganism. Glycopeptides have been used to treat EfARSV, with linezolid and daptomycin serving as potential alternative agents. Yet, the use of daptomycin is controversial due to a higher risk of treatment failures. Clinical evidence on this issue is scarce, unfortunately, and subject to many limitations. Despite increased incidence and mortality, EfARSV bacteremia presents multiple aspects to be addressed in well-conducted studies.