Table 4. Characteristics and outcomes of patients with breakthrough bacteremia due to Enterococcus faecium with different antibiotic susceptibility.
| # | Age, Sex | Underlying conditions | Isolate 1 (on day 1) | Isolate 2 | Isolate 3 | Outcome, Role of E. faecium in case of death | |||
|---|---|---|---|---|---|---|---|---|---|
| Type | SOURCE Antibiotic | Type (PFGEa) Day | SOURCE Antibiotic | Type (PFGEa) Day | SOURCE Antibiotic | ||||
| A | 62, M | Leukemia, Neutropenia |
VSE | CLABSI Dapto, Linez |
VRE (same) 1 |
CLABSI Dapto, Linez |
Discharge day 59 - |
||
| B | 73, F | Leukemia, Neutropenia |
VSE | CLABSI Vanco |
VRE (NA) 6 |
CLABSI Linez, Dapto |
Discharge day 24 - |
||
| C | 61, F | Leukemia, Neutropenia (Muc) |
VSE | ENDOCARD Dapto |
VSEb (same) 8 |
ENDOCARD Linez |
Death day 55 Contributed |
||
| D | 20, F | Liver transplant, Renal dialysis |
VSE | PRIMARY Vanco |
VRE (different) 15 |
CLABSI Dapto |
Death day 18 Contributed |
||
| E | 56, M | Leukemia, Neutro-penia, DM 2 |
VVE | PRIMARY Vanco |
VRE (NA) 6 |
PRIMARY Linez |
Death day 20 Unrelated |
||
| F | 66, M | Liver transplant, Dialysis, DM 2 |
VVE | IAI Linez, Dapto |
VVE (same) 34 |
IAI Dapto, Linez |
VVE (same) 43c |
IAI Linezolid |
Death day 101 Contributed |
| G | 22, M | Leukemia, Neutropenia (Muc) |
VRE | CLABSI Linez |
VSE (NA) 4 |
CLABSI Linez |
Death day 197 Unrelated |
||
| H | 63, M | Leukemia, Neutropenia (Muc) |
VRE | IAI Dapto |
VSE (relatedd) 21 |
IAI Vanco |
VRE (relatedd) 33 |
IAI Linezolid |
Death day 57 Unrelated |
| I | 63, M | Chondrosarcoma, DM 2 |
VRE | CAUTI Vanco, Linez |
VVE (same) 30 |
CLABSI Linez,Vanco |
Death day 154 Unrelated |
||
VRE, Vancomycin-resistant enterococci (i.e. vanA-positive and vancomycin-resistant OR vanB-positive); VVE, Vancomycin-variable enterococci (i.e. vanA-positive and vancomycin-susceptible); VSE, Vancomycin-susceptible enterococci (i.e. vanA- and vanB-negative); Muc, Mucositis; DM 2, Diabetes mellitus type 2; NA, Not Available (for typing); CLABSI, Central/Arterial Line Associated Blood Stream Infection; IAI, Intraabdominal Infection; ENDOCARD, Endocarditis; PRIMARY, Primary blood stream infection; CAUTI, Catheter Associated Urinary Tract Infection; Vanco, Vancomycin; Dapto, Daptomycin; Linez, Linezolid
aRelatedness of isolate from this blood culture to previous blood culture(s) based on Pulsed Field Gel Electrophoresis (PFGE)
bDaptomycin-resistant
cPatient had another VVE isolate (Linezolid-resistant) on day 59 with the same PFGE pattern. Treatment was switched to tigecycline and daptomycin.
dIsolate 2 was one band different to isolate 1, and isolate 3 was three bands different than isolate 2.