{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:11:29Z","timestamp":1790457089961,"version":"4.1.0"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X21002166_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      To study whether replacement of nosocomial ampicillin-resistant\n                      <jats:italic>Enterococcus faecium<\/jats:italic>\n                      (ARE) clones by vancomycin-resistant\n                      <jats:italic>E. faecium<\/jats:italic>\n                      (VRE), belonging to the same genetic lineages, increases mortality in patients with\n                      <jats:italic>E. faecium<\/jats:italic>\n                      bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective, matched-cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>The study included 20 Dutch and Danish hospitals from 2009 to 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06\u20132.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21002166_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2021.216","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T07:14:08Z","timestamp":1624259648000},"page":"719-727","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Attributable mortality of vancomycin resistance in ampicillin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    bacteremia in Denmark and the Netherlands: A matched cohort study"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-7969","authenticated-orcid":false,"given":"Wouter C.","family":"Rottier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Pinholt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akke K.","family":"van der Bij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Arpi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybrandus N.","family":"Blank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marrigje H.","family":"Nabuurs-Franssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gijs J.H.M.","family":"Ruijs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Tersmette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus M.","family":"Ossewaarde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf H.","family":"Groenwold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Westh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc J.M.","family":"Bonten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Dutch VRE Bacteremia Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Danish Collaborative Bacteraemia Network (DACOBAN)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"S0899823X21002166_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.2008.00383.x"},{"key":"S0899823X21002166_ref17","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S66998"},{"key":"S0899823X21002166_ref2","unstructured":"2. 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