Risk factors and outcomes associated with vancomycin-resistant Enterococcus faecium and ampicillin-resistant Enterococcus faecalis bacteraemia: A 10-year study in a tertiary-care centre in Mexico City.

Abstract Objectives In this study, we sought to identify risk factors associated with vancomycin-resistant E. faecium (VRE) and ampicillin-resistant E. faecalis (ARE) bacteremia, predictors associated with 30-day mortality, and 90-day recurrence-free survival rates according to resistance. Methods We evaluated the clinical records of patients with E. faecalis and E. faecium bacteremia from 2007 to 2017. We performed a bivariate and multivariate logistic regression analysis to identify the factors associated with VRE and ARE bacteremia, as well as the predictors of 30-day mortality. A Kaplan–Meier estimate of 90-day recurrence-free survival was done. Results We identified 192 and 147 episodes of E. faecium and E. faecalis bacteremia, respectively. Fifty-six percent of the E. faecium episodes corresponded to VRE (94% harbored vanA gene), and 12% of E. faecalis events belonged to ARE. Factors related to VRE bacteremia were a previous hospitalization (aOR, 80.18; 95% CI, 1.81 – 634), the history of central venous catheter placement (aOR, 11.15; 95% CI, 2.48-50.2), and endotracheal cannula use (aOR, 17.91; 95% CI, 1.22-262). There was a higher attributable mortality to VRE 28% (95% IC: 14%-68%, P  Conclusions A history of hospitalization and invasive device use was related to VRE bacteremia. The APACHE II score and a history of chemotherapy were predictors of mortality. We could identify neither related factor with ARE nor predictors of mortality.