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    Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022
    (2024)
    Kasim Allel
    ;
    Anne Peters
    ;
    Hassan Haghparast-Bidgoli
    ;
    Maria Spencer-Sandino
    ;
    Jose Conejeros
    Scopus© Citations 2  4
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    Item type:Publication,
      10Scopus© Citations 44
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    Item type:Publication,
    Multisite Detection of Tn
    <i>1549</i>
    -Mediated
    <i>vanB</i>
    Vancomycin Resistance in Multidrug-Resistant Enterococcus faecalis ST6 in Texas and Florida
    (2023)
    Shelby R. Simar
    ;
    Truc T. Tran
    ;
    Kirsten B. Rydell
    ;
    Diana Panesso
    ;
    German A. Contreras
    <jats:p> In the United States, <jats:italic>vanB</jats:italic> -mediated resistance in enterococci is rare. We characterized three sequence type (ST) 6, vancomycin-resistant <jats:named-content content-type="genus-species">Enterococcus faecalis</jats:named-content> isolates causing bacteremia in unique patients in spatiotemporally distinct settings. </jats:p>
      7  1Scopus© Citations 3
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    Antimicrobial Susceptibility Testing for Enterococci
    (2022)
    Ayesha Khan
    ;
    William R. Miller
    ;
    Dierdre Axell-House
    ;
    MUNITA SEPULVEDA, JOSE MANUEL  
    ;
    Cesar A. Arias
    <jats:p>Enterococci are major, recalcitrant nosocomial pathogens with a wide repertoire of intrinsic and acquired resistance determinants and the potential of developing resistance to all clinically available antimicrobials. As such, multidrug-resistant enterococci are considered a serious public health threat.</jats:p>
      1Scopus© Citations 57  1
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    Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I)
    (2021)
    German A Contreras
    ;
    MUNITA SEPULVEDA, JOSE MANUEL  
    ;
    Shelby Simar
    ;
    Courtney Luterbach
    ;
    An Q Dinh
    <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The Vancomycin-Resistant Enterococcal BSI Outcomes Study (VENOUS I) is a prospective observational cohort of adult patients with enterococcal BSI in 11 US hospitals. We included patients with Enterococcus faecalis or Enterococcus faecium BSI with ≥1 follow-up blood culture(s) within 7 days and availability of isolate(s) for further characterization. The primary study outcome was in-hospital mortality. Secondary outcomes were mortality at days 4, 7, 10, 12, and 15 after index blood culture. A desirability of outcome ranking was constructed to assess the association of vancomycin resistance with outcomes. All index isolates were subjected to whole genome sequencing.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Forty-two of 232 (18%) patients died in hospital and 39 (17%) exhibited microbiological failure (lack of clearance in the first 4 days). Neutropenia (hazard ratio [HR], 3.13), microbiological failure (HR, 2.4), VRE BSI (HR, 2.13), use of urinary catheter (HR, 1.85), and Pitt BSI score ≥2 (HR, 1.83) were significant predictors of in-hospital mortality. Microbiological failure was the strongest predictor of in-hospital mortality in patients with E faecium bacteremia (HR, 5.03). The impact of vancomycin resistance on mortality in our cohort changed throughout the course of hospitalization. Enterococcus faecalis sequence type 6 was a predominant multidrug-resistant lineage, whereas a heterogeneous genomic population of E faecium was identified.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes.</jats:p> </jats:sec>
      5Scopus© Citations 42
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      7Scopus© Citations 553
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    Scopus© Citations 170  2
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    What's New in the Treatment of Enterococcal Endocarditis?
    (2014)
    Masayuki Nigo
    ;
    MUNITA SEPULVEDA, JOSE MANUEL  
    ;
    Cesar A. Arias
    ;
    Barbara E. Murray
      27Scopus© Citations 49