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Retrospective analysis of hospital-acquired linezolid-nonsusceptible enterococci infection in Chongqing, China, 2011-2014

Published:August 25, 2015DOI:https://doi.org/10.1016/j.ajic.2015.07.027

      Highlights

      • We found transferring from another hospital was a unique independent predictor for acquiring linezolid-nonsusceptible enterococci.
      • Our findings suggest that gallbladder disease was significantly associated with linezolid-susceptible enterococci infection.
      • Polymicrobial infection was the only factor identified in both linezolid-nonsusceptible and linezolid-susceptible enterococci groups compared with controls; however, there was no significant difference between linezolid-nonsusceptible and linezolid-susceptible enterococci groups.
      • We found there was no statistical significance between cases and controls with respect to in-hospital mortality.

      Background

      Linezolid-nonsusceptible enterococci (LNSE) is an increasingly emerging multidrug-resistant pathogen, and the caused nosocomial infections are difficult to manage. However, data on the host-related risk factors and clinical outcomes for LNSE infection are poorly characterized.

      Methods

      A retrospective case-case-control study of risk factors and clinical outcomes of hospitalized patients with LNSE infection during the period 2011-2014 was conducted in a teaching hospital in Chongqing, China. Case patients with LNSE and those with linezolid-susceptible enterococci (LSE) and controls with no enterococcal infection were compared at a ratio of 1:1:4. Two parallel multivariate logistic regression models were used to evaluate independent predictors for acquiring LNSE and LSE, respectively.

      Results

      Forty-four LNSE cases, 44 LSE cases, and 176 uninfected controls were analyzed. Multivariable analysis indicated that transferring from another hospital (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.58-8.09), peripheral vascular disease (OR, 4.36; 95% CI, 1.64-11.60), and exposure to cephalosporins (OR, 4.24; 95% CI, 1.85-9.71) were unique independent predictors for acquiring LNSE. Gallbladder disease (OR, 3.64; 95% CI, 1.36-9.74) was independently associated with LSE acquisition. Polymicrobial infection was the only factor identified in both LNSE and LSE groups compared with controls; however, no statistical significance was observed in in-hospital mortality.

      Conclusion

      Timely control efforts and appropriate antibiotic stewardship programs are necessary to effectively reduce the burden of LNSE infections among high-risk patients.

      Key Words

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