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Storm JC, Diekema DJ, Kroeger JS, et al. Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus. Antimicrob Resist Infect Control. 2012;1(1):19doi: 10.1186/2047-2994-1-19.
Storm, J. C., Diekema, D. J., Kroeger, J. S., Johnson, S. J., & Johannsson, B. (2012). Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus. Antimicrobial resistance and infection control, 1(1), 19. https://doi.org/10.1186/2047-2994-1-19
Storm, Jeremy C, et al. "Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus." Antimicrobial resistance and infection control vol. 1,1 (2012): 19. doi: https://doi.org/10.1186/2047-2994-1-19
Storm JC, Diekema DJ, Kroeger JS, Johnson SJ, Johannsson B. Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus. Antimicrob Resist Infect Control. 2012 May 29;1(1):19. doi: 10.1186/2047-2994-1-19. PMID: 22958379; PMCID: PMC3436660.
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Antimicrob Resist Infect Control. 2012 May 29;1(1):19. doi: 10.1186/2047-2994-1-19.

Daptomycin exposure precedes infection and/or colonization with daptomycin non-susceptible enterococcus.

Antimicrobial resistance and infection control

Jeremy C Storm, Daniel J Diekema, Jennifer S Kroeger, Sarah J Johnson, Birgir Johannsson

Affiliations

  1. University of Iowa Hospital and Clinics, Iowa City, IA, USA. [email protected].

PMID: 22958379 PMCID: PMC3436660 DOI: 10.1186/2047-2994-1-19

Abstract

BACKGROUND: Daptomycin non-susceptible enterococci (DNSE) are emerging as an important cause of healthcare-associated infection, however little is known about the epidemiology of DNSE. At the University of Iowa Hospitals and Clinics (UIHC) an increase in the frequency of patients infected and/or colonized with DNSE has occurred. The goals of this study were to evaluate potential factors associated with the development of DNSE colonization and/or infection and to compare the characteristics of patients with prior daptomycin exposure to those without prior daptomycin exposure.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

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