Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure

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dc.contributor.authorDiPippo, Adam
dc.contributor.authorTverdek, Frank
dc.contributor.authorTarrand, Jeffrey
dc.contributor.authorMunita, José
dc.contributor.authorTran, Truc
dc.contributor.authorArias, Cesar
dc.contributor.authorShelburne, Samuel
dc.contributor.authorAitken, Samuel L.
dc.date.accessioned2017-08-10T20:05:11Z
dc.date.available2017-08-10T20:05:11Z
dc.date.issued2016
dc.description.abstractOBJECTIVES: We sought to determine the association between previous daptomycin exposure and daptomycin non-susceptible Enterococcus faecium (DNSEf) bloodstream infections (BSI) in adult leukemia patients. METHODS: We retrospectively identified adult (≥18 years old) leukemia patients with Enterococcus spp. bacteremia at The University of Texas MD Anderson Cancer Center (MDACC) from 6/1/2013 to 7/22/2015. Antimicrobial susceptibility and previous antibiotic exposure within the 90 days prior to bacteremia were collected. Classification and Regression Tree (CART) analysis was used to identify the most significant breakpoint between daptomycin exposure and DNSEf. RESULTS: Any amount of daptomycin received within the 90 days preceding BSI was significantly associated with isolation of DNSEf compared to daptomycin susceptible E. faecium (DSEf) (88% vs. 44%, respectively, p < 0.01). CART analysis identified receiving ≥13 days of daptomycin in the preceding 90 days as most significantly correlated with DNSEf (60% vs. 11%, relative risk [RR] 5.31, 95% Confidence interval [CI] 2.36-11.96, p < 0.01). CONCLUSIONS: Prior daptomycin exposure for ≥13 days within 90 days preceding BSI was significantly associated with isolation of DNSEf BSI in adult leukemia patients at our institution. Antimicrobial stewardship initiatives aimed at minimizing daptomycin exposure in high-risk patients may be of significant benefit in limiting the emergence of DNSEf.
dc.format.extent5
dc.identifier.citationDiPippo AJ, Tverdek FP, Tarrand JJ, Munita JM, Tran TT, Arias CA, Shelburne SA, Aitken SL. Daptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure. J Infect. 2017 Mar;74(3):243-247.
dc.identifier.urihttp://hdl.handle.net/11447/1561
dc.identifier.urihttp://dx.doi.org/10.1016/j.jinf.2016.11.004
dc.language.isoen_US
dc.publisherElsevier
dc.subjectAntibiotic exposure
dc.subjectLinezolid
dc.subjectResistance
dc.subjectRisk factor
dc.subjectVancomycin
dc.titleDaptomycin non-susceptible Enterococcus faecium in leukemia patients: Role of prior daptomycin exposure
dc.typeArtículo

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