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    Int J Antimicrob Agents. 2004 Feb;23(2):200-3.

    Emergence of resistance to chloramphenicol among vancomycin-resistant enterococcal (VRE) bloodstream isolates.

    Lautenbach E, Gould CV, LaRosa LA, Marr AM, Nachamkin I, Bilker WB, Fishman NO.

    Source

    Department of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 825 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. elautenb@cceb.med.upenn.edu

    Abstract

    Therapeutic options for vancomycin-resistant enterococcal (VRE) bloodstream infections are extremely limited. Chloramphenicol is effective when VRE isolates are susceptible to this agent. However, longitudinal trends in chloramphenicol-resistant VRE (CR-VRE) are unknown. The possible association between CR-VRE and antibiotic use has not been studied. We analyzed the antimicrobial susceptibility profiles of all VRE blood isolates from 1991-2000 at our institution. We performed a correlational study to examine the relationship between annual hospital-wide use of specific antibiotics and antibiotic classes and CR-VRE prevalence. During the 10-year study period, the prevalence of CR-VRE increased from 0 to 11% ( P< 0.001, trend). CR-VRE prevalence was correlated only with chloramphenicol use (P=0.05 ) and quinolone use (P= 0.01 ). If these trends continue, dependence on newer, more expensive agents will increase. The correlation between both chloramphenicol use and quinolone use and the prevalence of CR-VRE suggests that efforts to preserve the utility of chloramphenicol in VRE infections may depend on optimizing the use of these agents.

    PMID:
    15013047
    [PubMed - indexed for MEDLINE]

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