%0 Journal Article
%T Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus
%A Jeremy C Storm
%A Daniel J Diekema
%A Jennifer S Kroeger
%A Sarah J Johnson
%A Birgir Johannsson
%J Antimicrobial Resistance and Infection Control
%D 2012
%I BioMed Central
%R 10.1186/2047-2994-1-19
%X The study is a retrospective case-series involving all patients with DNSE infection and/or colonization at UIHC, a 734-bed academic referral center, from June 1, 2005 to June 1, 2011.The majority of patients with DNSE colonization and/or infection had prior daptomycin exposure (15 of 25; 60%), a concomitant gastrointestinal process (19 of 25; 76%), or were immunosuppressed (21 of 25; 84%). DNSE infection was confirmed in 17 of 25 (68%) patients, including 9 patients with bacteremia. Twelve of 17 (71%) patients with DNSE infection had prior daptomycin exposure, including 7 of 9 (78%) patients with bacteremia. Compared to patients without prior daptomycin exposure, patients with prior daptomycin exposure were less likely to harbor E. faecalis (0% vs. 33%; p£¿=£¿0.019). A high proportion of patients (10 of 25; 40%) died during their hospitalizations. Most enterococcal isolates were E. faecium (86%), and were vancomycin-resistant (72%). Molecular typing revealed a diverse population of DNSE.Prior daptomycin exposure, immunosuppression, and/or a concomitant gastrointestinal process, may be associated with the development of DNSE. PFGE revealed a diverse population of DNSE, which along with both increasing numbers of DNSE detected yearly and increasing annual rates of daptomycin usage, suggests the emergence of DNSE under antimicrobial pressure.
%K Enterococcus
%K Daptomycin
%K Resistance
%K Non-Susceptible
%K DNSE
%U http://www.aricjournal.com/content/1/1/19/abstract