Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection
Objectives: We analyzed the risk factors affecting linezolid treatment outcome in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Methods: We conducted a multicenter observational study of patients who received linezolid 600 mg every 12 hours for VRE BSI. The primary outcome was...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223000358 |
| _version_ | 1797868273808703488 |
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| author | Szu-Ting Huang Jia-Ling Yang Chi-Ying Lin Sung-Hsi Huang Jann-Tay Wang Yu-Chung Chuang Yee-Chun Chen Shan-Chwen Chang |
| author_facet | Szu-Ting Huang Jia-Ling Yang Chi-Ying Lin Sung-Hsi Huang Jann-Tay Wang Yu-Chung Chuang Yee-Chun Chen Shan-Chwen Chang |
| author_sort | Szu-Ting Huang |
| collection | DOAJ |
| description | Objectives: We analyzed the risk factors affecting linezolid treatment outcome in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Methods: We conducted a multicenter observational study of patients who received linezolid 600 mg every 12 hours for VRE BSI. The primary outcome was 28-day mortality. The estimated area under the concentration-time curve and trough concentration were calculated. Multivariable logistic regression was used for the outcome analysis. Results: A total of 170 patients were included: 114 (67.1%) survived and 56 (32.9%) did not. A total of 26 (18.2%) isolates showed a linezolid minimum inhibitory concentration (MIC) of ≤1 mg/l, 113 (79.0%) of 2 mg/l, and 4 (2.8%) of 4 mg/l. The univariable analysis showed that the linezolid MIC and concentration-time curve/MIC were not associated with mortality (P = 0.95 and P = 0.42, respectively). After adjusting for underlying comorbidity and disease severity, the linezolid dose per body weight (LDBW), body height, and interaction between them were independent risks for mortality. Marginal analysis showed that increasing the LDBW was protective in patients with a body height <160 cm. A trough concentration of >12.2 mg/l was a risk factor for thrombocytopenia. Conclusion: The LDBW and body height were interactively associated with clinical outcomes of linezolid treatment for VRE BSI. |
| first_indexed | 2024-04-09T23:54:27Z |
| format | Article |
| id | doaj.art-3d2d64a27e1a4961b0e6798aed200b95 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-09T23:54:27Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-3d2d64a27e1a4961b0e6798aed200b952023-03-17T04:32:46ZengElsevierInternational Journal of Infectious Diseases1201-97122023-04-0112996102Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infectionSzu-Ting Huang0Jia-Ling Yang1Chi-Ying Lin2Sung-Hsi Huang3Jann-Tay Wang4Yu-Chung Chuang5Yee-Chun Chen6Shan-Chwen Chang7Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author: Tel: 886-2-23123456 ext. 63015; Fax: 886-2-23971412Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanObjectives: We analyzed the risk factors affecting linezolid treatment outcome in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Methods: We conducted a multicenter observational study of patients who received linezolid 600 mg every 12 hours for VRE BSI. The primary outcome was 28-day mortality. The estimated area under the concentration-time curve and trough concentration were calculated. Multivariable logistic regression was used for the outcome analysis. Results: A total of 170 patients were included: 114 (67.1%) survived and 56 (32.9%) did not. A total of 26 (18.2%) isolates showed a linezolid minimum inhibitory concentration (MIC) of ≤1 mg/l, 113 (79.0%) of 2 mg/l, and 4 (2.8%) of 4 mg/l. The univariable analysis showed that the linezolid MIC and concentration-time curve/MIC were not associated with mortality (P = 0.95 and P = 0.42, respectively). After adjusting for underlying comorbidity and disease severity, the linezolid dose per body weight (LDBW), body height, and interaction between them were independent risks for mortality. Marginal analysis showed that increasing the LDBW was protective in patients with a body height <160 cm. A trough concentration of >12.2 mg/l was a risk factor for thrombocytopenia. Conclusion: The LDBW and body height were interactively associated with clinical outcomes of linezolid treatment for VRE BSI.http://www.sciencedirect.com/science/article/pii/S1201971223000358LinezolidPharmacodynamicMortalityVancomycin-resistant enterococci |
| spellingShingle | Szu-Ting Huang Jia-Ling Yang Chi-Ying Lin Sung-Hsi Huang Jann-Tay Wang Yu-Chung Chuang Yee-Chun Chen Shan-Chwen Chang Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection International Journal of Infectious Diseases Linezolid Pharmacodynamic Mortality Vancomycin-resistant enterococci |
| title | Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection |
| title_full | Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection |
| title_fullStr | Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection |
| title_full_unstemmed | Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection |
| title_short | Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection |
| title_sort | risk factors for mortality after linezolid treatment of vancomycin resistant enterococcus bloodstream infection |
| topic | Linezolid Pharmacodynamic Mortality Vancomycin-resistant enterococci |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223000358 |
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